This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions
. Page versions: R4B R4 R3
| Vocabulary Work Group | Maturity Level: N/A | Ballot Status: Informative |
Definition for Code System Adjudication Value Codes
{
"resourceType": "CodeSystem",
"id": "adjudication",
"meta": {
"lastUpdated": "2017-12-20T15:52:34.818+11:00",
"profile": [
"http://hl7.org/fhir/StructureDefinition/shareablecodesystem"
]
},
"text": {
"status": "generated",
"div": "<div>!-- Snipped for Brevity --></div>"
},
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "fm"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-ballot-status",
"valueString": "Draft"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 1
}
],
"url": "http://hl7.org/fhir/adjudication",
"identifier": {
"system": "urn:ietf:rfc:3986",
"value": "urn:oid:2.16.840.1.113883.4.642.1.597"
},
"version": "3.2.0",
"name": "Adjudication Value Codes",
"status": "draft",
"experimental": true,
"publisher": "FHIR Project team",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "http://hl7.org/fhir"
}
]
}
],
"description": "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": "This is an example set.",
"caseSensitive": true,
"valueSet": "http://hl7.org/fhir/ValueSet/adjudication",
"content": "complete",
"concept": [
{
"code": "total",
"display": "Total",
"definition": "Total submitted"
},
{
"code": "copay",
"display": "CoPay",
"definition": "Patient Co-Payment"
},
{
"code": "eligible",
"display": "Eligible Amount",
"definition": "Amount of the change which is considered for adjudication"
},
{
"code": "deductible",
"display": "Deductable",
"definition": "Amount deducted from the eligible amount prior to adjudication"
},
{
"code": "eligpercent",
"display": "Eligible %",
"definition": "Eligible Percentage"
},
{
"code": "tax",
"display": "Emergency Department",
"definition": "Emergency Department"
},
{
"code": "benefit",
"display": "Benefit Amount",
"definition": "Amount payable under the coverage"
}
]
}
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.