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Financial Management Work Group | Maturity Level: N/A | Standards Status: Informative |
Raw XML (canonical form + also see XML Format Specification)
Definition for Code SystemClaimProcessingCodes
<?xml version="1.0" encoding="UTF-8"?> <CodeSystem xmlns="http://hl7.org/fhir"> <id value="eligibility-outcome"/> <meta> <lastUpdated value="2023-03-26T15:21:02.749+11:00"/> <profile value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/> </meta> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p> This code system <code> http://hl7.org/fhir/eligibility-outcome</code> defines the following codes: </p> <table class="codes"> <tr> <td style="white-space:nowrap"> <b> Code</b> </td> <td> <b> Display</b> </td> <td> <b> Definition</b> </td> </tr> <tr> <td style="white-space:nowrap">queued <a name="eligibility-outcome-queued"> </a> </td> <td> Queued</td> <td> The Claim/Pre-authorization/Pre-determination has been received but processing has not begun.</td> </tr> <tr> <td style="white-space:nowrap">complete <a name="eligibility-outcome-complete"> </a> </td> <td> Processing Complete</td> <td> The processing has completed without errors</td> </tr> <tr> <td style="white-space:nowrap">error <a name="eligibility-outcome-error"> </a> </td> <td> Error</td> <td> One or more errors have been detected in the Claim</td> </tr> <tr> <td style="white-space:nowrap">partial <a name="eligibility-outcome-partial"> </a> </td> <td> Partial Processing</td> <td> No errors have been detected in the Claim and some of the adjudication has been performed.</td> </tr> </table> </div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="fm"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"> <valueCode value="trial-use"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="2"/> </extension> <url value="http://hl7.org/fhir/eligibility-outcome"/> <identifier> <system value="urn:ietf:rfc:3986"/> <value value="urn:oid:2.16.840.1.113883.4.642.4.2072"/> </identifier> <version value="5.0.0"/> <name value="ClaimProcessingCodes"/> <title value="Claim Processing Codes"/> <status value="active"/> <experimental value="false"/> <publisher value="FHIR Project team"/> <contact> <telecom> <system value="url"/> <value value="http://hl7.org/fhir"/> </telecom> </contact> <description value="This value set includes Claim Processing Outcome codes."/> <jurisdiction> <coding> <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/> <code value="001"/> <display value="World"/> </coding> </jurisdiction> <copyright value="HL7 Inc."/> <caseSensitive value="true"/> <valueSet value="http://hl7.org/fhir/ValueSet/eligibility-outcome"/> <content value="complete"/> <concept> <code value="queued"/> <display value="Queued"/> <definition value="The Claim/Pre-authorization/Pre-determination has been received but processing has not begun."/> </concept> <concept> <code value="complete"/> <display value="Processing Complete"/> <definition value="The processing has completed without errors"/> </concept> <concept> <code value="error"/> <display value="Error"/> <definition value="One or more errors have been detected in the Claim"/> </concept> <concept> <code value="partial"/> <display value="Partial Processing"/> <definition value="No errors have been detected in the Claim and some of the adjudication has been performed."/> </concept> </CodeSystem>
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.
FHIR ®© HL7.org 2011+. FHIR R5 hl7.fhir.core#5.0.0 generated on Sun, Mar 26, 2023 15:22+1100.
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