Release 5 Ballot

This page is part of the FHIR Specification (v5.0.0-ballot: R5 Ballot - see ballot notes). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

Example CodeSystem/claim-decision (Turtle)

Financial Management Work GroupMaturity Level: N/AStandards Status: Informative

Raw Turtle (+ also see Turtle/RDF Format Specification)

Definition for Code SystemClaimAdjudicationDecisionCodes

@prefix fhir: <http://hl7.org/fhir/> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .

# - resource -------------------------------------------------------------------

[] a fhir:CodeSystem;
  fhir:Resource.id [ fhir:value "claim-decision"];
  fhir:Resource.meta [
     fhir:Meta.lastUpdated [ fhir:value "2022-09-10T04:52:37.223+10:00" ];
     fhir:Meta.profile [ fhir:value "http://hl7.org/fhir/StructureDefinition/shareablecodesystem" ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ]
  ];
  fhir:DomainResource.extension [
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg" ];
     fhir:Extension.value [ fhir:value "fm" ]
  ];
  fhir:CanonicalResource.url [ fhir:value "http://hl7.org/fhir/claim-decision"];
  fhir:CanonicalResource.identifier [
     fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ];
     fhir:Identifier.value [ fhir:value "urn:oid:2.16.840.1.113883.4.642.4.1896" ]
  ];
  fhir:CanonicalResource.version [ fhir:value "5.0.0-ballot"];
  fhir:CanonicalResource.name [ fhir:value "ClaimAdjudicationDecisionCodes"];
  fhir:CanonicalResource.title [ fhir:value "Claim Adjudication Decision Codes"];
  fhir:CanonicalResource.status [ fhir:value "draft"];
  fhir:CanonicalResource.experimental [ fhir:value "false"];
  fhir:CanonicalResource.description [ fhir:value "This value set provides Claim Adjudication Decision codes."];
  fhir:CanonicalResource.copyright [ fhir:value "HL7 Inc."];
  fhir:CodeSystem.url [ fhir:value "http://hl7.org/fhir/claim-decision"];
  fhir:CodeSystem.identifier [
     fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ];
     fhir:Identifier.value [ fhir:value "urn:oid:2.16.840.1.113883.4.642.4.1896" ]
  ];
  fhir:CodeSystem.version [ fhir:value "5.0.0-ballot"];
  fhir:CodeSystem.name [ fhir:value "ClaimAdjudicationDecisionCodes"];
  fhir:CodeSystem.title [ fhir:value "Claim Adjudication Decision Codes"];
  fhir:CodeSystem.status [ fhir:value "draft"];
  fhir:CodeSystem.experimental [ fhir:value "false"];
  fhir:CodeSystem.description [ fhir:value "This value set provides Claim Adjudication Decision codes."];
  fhir:CodeSystem.copyright [ fhir:value "HL7 Inc."];
  fhir:CodeSystem.caseSensitive [ fhir:value "true"];
  fhir:CodeSystem.content [ fhir:value "complete"];
  fhir:CodeSystem.concept [
     fhir:ConceptDefinitionComponent.code [ fhir:value "denied" ];
     fhir:ConceptDefinitionComponent.display [ fhir:value "Denied" ];
     fhir:ConceptDefinitionComponent.definition [ fhir:value "The claim, or individual services, are not approved for any payment. This may also be known as 'rejected'." ]
  ], [
     fhir:ConceptDefinitionComponent.code [ fhir:value "approved" ];
     fhir:ConceptDefinitionComponent.display [ fhir:value "Approved" ];
     fhir:ConceptDefinitionComponent.definition [ fhir:value "The claim, or individual services, are approved as submitted." ]
  ], [
     fhir:ConceptDefinitionComponent.code [ fhir:value "partial" ];
     fhir:ConceptDefinitionComponent.display [ fhir:value "Partial" ];
     fhir:ConceptDefinitionComponent.definition [ fhir:value "The claim, or individual services, are approved at an amount less than as submitted." ]
  ], [
     fhir:ConceptDefinitionComponent.code [ fhir:value "pending" ];
     fhir:ConceptDefinitionComponent.display [ fhir:value "Pending" ];
     fhir:ConceptDefinitionComponent.definition [ fhir:value "The adjudication processing is not complete. This may be due to requiring manual review or receipt of additional information." ]
  ] .

# -------------------------------------------------------------------------------------


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.