Release 4
This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU ). This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

4.3.14.191 4.3.14.273 Code System http://terminology.hl7.org/CodeSystem/adjudication

Financial Management Work Group   Maturity Level : 1 Draft Use Context : Any

This is a code system defined by the FHIR project.

Summary

Defining URL: http://terminology.hl7.org/CodeSystem/adjudication
Version: 4.0.1 4.2.0
Name: AdjudicationValueCodes
Title: Adjudication Value Codes
Definition:

This value set includes a smattering of Adjudication Value codes which includes codes to indicate the amounts eligible under the plan, the amount of benefit, copays etc.

Committee: Financial Management Work Group
OID: 2.16.840.1.113883.4.642.4.1171 2.16.840.1.113883.4.642.1.1171 (for OID based terminology systems)
Copyright:

This is an example set.

Source Resource XML / JSON

This Code system is used in the following value sets:

  • ValueSet: Adjudication Value Codes (This value set includes a smattering of Adjudication Value codes which includes codes to indicate the amounts eligible under the plan, the amount of benefit, copays etc.)
  • ValueSet: Adjudication Value Codes (This value set includes a smattering of Adjudication Value codes which includes codes to indicate the amounts eligible under the plan, the amount of benefit, copays etc.)

This value set includes a smattering of Adjudication Value codes which includes codes to indicate the amounts eligible under the plan, the amount of benefit, copays etc.

Copyright Statement: This is an example set.

This code system http://terminology.hl7.org/CodeSystem/adjudication defines the following codes:
Code Display Definition
submitted Submitted Amount The total submitted amount for the claim or group or line item.
copay CoPay Patient Co-Payment
eligible Eligible Amount Amount of the change which is considered for adjudication.
deductible Deductible Amount deducted from the eligible amount prior to adjudication.
unallocdeduct Unallocated Deductible The amount of deductible which could not allocated to other line items.
eligpercent Eligible % Eligible Percentage.
tax Tax The amount of tax.
benefit Benefit Amount Amount payable under the coverage

 

See the full registry of code systems defined as part of FHIR.


Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. See Code System for further information.
Source The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance). If the code is in italics, this indicates that the code is not selectable ('Abstract')
Display The display (used in the display element of a Coding ). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code