Activity performed for or on a patient as part of the provision of care.

Data Element

Reason for Referral

Explanation or justification for a referral or consultation.


NCPDP Comments on USCDI draft v5

NCPDP applauds the addition of SNOMED CT codes to the applicable vocabulary standards.

NCPDP Comment

NCPDP recommends the use of SNOMED CT codes. Pharmacists document “Reason for Referral" in the NCPDP/HL7 Pharmacist eCare Plan using SNOMED CT codes. For example, used within the NCPDP/HL7 Pharmacist eCare Plan, the SNOMED CT codes are in two value sets the NLM VSAC “PharmacyReferralsTo” OID 2.16.840.1.113762.1.4.1096.203 and “PharmacyReferralsFrom” OID 2.16.840.1.113762.1.4.1096.216.

NCPDP Comments

NCPDP recommends the use of SNOMED CT. Pharmacists document “Reason for Referral" in the NCPDP/HL7 Pharmacist eCare Plan using SNOMED CT.  These SNOMED CT codes are in 2 value sets the NLM VSAC “PharmacyReferralsTo” OID 2.16.840.1.113762.1.4.1096.203 and “PharmacyReferralsFrom” OID 2.16.840.1.113762.1.4.1096.216.

Lantana Consulting Group Comment

The data element Reason for Referral is listed under Procedures; however, referrals are not limited to the completion of a procedure. Orders often include referrals but can be considered as a Plan of Treatment. We note that in C-CDA, referrals are listed as part of the plan of treatment. Lantana recommends placing this data element under Care and Treatment Plans category.

Unified Comment from CDC

  • Referral data elements, such as reason, requestor, and coverage, are important to support CDC’s efforts in streamlining the efficient exchange of health information between healthcare providers and principally extra-clinical program service systems that reside in community services, lifestyle change, public health, and other organizations. These data elements play a major role in identifying appropriate services based on the patient’s health needs and aid in ensuring appropriate parties involved in the overall health and wellbeing of the patient are receiving information regarding the patient intake outcome, referral service provisioning, and final referral outcome. The referral data elements are also useful to understand how often patients are referred to specialist for occupational illnesses.
  • Support for healthcare aims:  Also supports Improving health of populations and Reducing cost of care, Improving provider experience of care.
  • Additional Technical Specification: Bidirectional Services eReferrals (BSeR) FHIR Implementation Guide

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