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TX: CodeSystem claim-decision

Properties

Profile http://hl7.org/fhir/StructureDefinition/shareablecodesystem
Defining URL http://hl7.org/fhir/claim-decision
Version 5.0.0
Name ClaimAdjudicationDecisionCodes
Title Claim Adjudication Decision Codes
Status active
Definition

This value set provides Claim Adjudication Decision codes.
Publisher HL7 International
Committee fm
Copyright HL7 Inc.

This case-sensitive code system http://hl7.org/fhir/claim-decision defines the following codes:

Code Display Definition
denied Denied The claim, or individual services, are not approved for any payment. This may also be known as 'rejected'.
approved Approved The claim, or individual services, are approved as submitted.
partial Partial The claim, or individual services, are approved at an amount less than as submitted.
pending Pending The adjudication processing is not complete. This may be due to requiring manual review or receipt of additional information.