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 . Page versions: R5 R4B R4 R3 R2
Financial Management Work Group | Maturity Level: 1 | Draft | Use Context: Not Intended for Production use, Not Intended for Production use |
This is a value set defined by the FHIR project.
Summary
Defining URL: | http://hl7.org/fhir/ValueSet/adjudication |
Version: | 5.0.0-ballot |
Name: | AdjudicationValueCodes |
Title: | Adjudication Value Codes |
Status: | draft |
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: | 2.16.840.1.113883.4.642.3.596 (for OID based terminology systems) |
Copyright: | This is an example set. |
Flags: | Experimental |
This value set is used in the following places:
http://terminology.hl7.org/CodeSystem/adjudication
This expansion generated 10 Sep 2022
This value set contains 8 concepts
Expansion based on Adjudication Value Codes v0.1.0 (CodeSystem)
Code | System | Display | Definition |
submitted | http://terminology.hl7.org/CodeSystem/adjudication | Submitted Amount | The total submitted amount for the claim or group or line item. |
copay | http://terminology.hl7.org/CodeSystem/adjudication | CoPay | Patient Co-Payment |
eligible | http://terminology.hl7.org/CodeSystem/adjudication | Eligible Amount | Amount of the change which is considered for adjudication. |
deductible | http://terminology.hl7.org/CodeSystem/adjudication | Deductible | Amount deducted from the eligible amount prior to adjudication. |
unallocdeduct | http://terminology.hl7.org/CodeSystem/adjudication | Unallocated Deductible | The amount of deductible which could not allocated to other line items. |
eligpercent | http://terminology.hl7.org/CodeSystem/adjudication | Eligible % | Eligible Percentage. |
tax | http://terminology.hl7.org/CodeSystem/adjudication | Tax | The amount of tax. |
benefit | http://terminology.hl7.org/CodeSystem/adjudication | Benefit Amount | Amount payable under the coverage |
See the full registry of value sets defined as part of FHIR.
Explanation of the columns that may appear on this page:
Lvl | A few code lists that FHIR defines are hierarchical - each code is assigned a level. For value sets, levels are mostly used to organize codes for user convenience, but may follow code system hierarchy - 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 |