FHIR Release 3 (STU)

This page is part of the FHIR Specification (v3.0.2: STU 3). 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

4.2.12.589 Code System http://hl7.org/fhir/adjudication

Vocabulary Work Group Maturity Level: 1InformativeUse Context: Not Intended for Production use

This is a code system defined by the FHIR project.

Summary

Defining URL:http://hl7.org/fhir/adjudication
Name: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:2.16.840.1.113883.4.642.1.589 (for OID based terminology systems)
Copyright:This is an example set.
Source ResourceXML / JSON

This Code system is used in the following value sets:

  • 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.)

4.2.12.589.1 Content

4.2.12.589.2 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.

Copyright Statement: This is an example set.

This code system http://hl7.org/fhir/adjudication defines the following codes:

CodeDisplayDefinition
total TotalTotal submitted
copay CoPayPatient Co-Payment
eligible Eligible AmountAmount of the change which is considered for adjudication
deductible DeductableAmount deducted from the eligible amount prior to adjudication
eligpercent Eligible %Eligible Percentage
tax Emergency DepartmentEmergency Department
benefit Benefit AmountAmount 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:

LevelA few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
SourceThe source of the definition of the code (when the value set draws in codes defined elsewhere)
CodeThe code (used as the code in the resource instance). If the code is in italics, this indicates that the code is not selectable ('Abstract')
DisplayThe 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
DefinitionAn explanation of the meaning of the concept
CommentsAdditional notes about how to use the code