This page is part of the CARIN Blue Button Implementation Guide (v0.1.0: STU 1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.1.0. For a full list of available versions, see the Directory of published versions
JSON Format: CodeSystem-CARIN-BB-Adjudication-Category
Raw json
{
"resourceType" : "CodeSystem",
"id" : "CARIN-BB-Adjudication-Category",
"meta" : {
"versionId" : "4",
"lastUpdated" : "2019-12-01T18:53:17.000+00:00"
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>CARIN Blue Button Claim Adjudication Category Code System</h2><p>This code system http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-adjudicationcategory 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\">benefitPaymentStatusCode<a name=\"CARIN-BB-Adjudication-Category-benefitPaymentStatusCode\"> </a></td><td>Benefit payment status code</td><td>Benefit payment status code</td></tr><tr><td style=\"white-space:nowrap\">paymentDenialCode<a name=\"CARIN-BB-Adjudication-Category-paymentDenialCode\"> </a></td><td>Payment denial code</td><td>Payment Denial Code</td></tr><tr><td style=\"white-space:nowrap\">submittedamount<a name=\"CARIN-BB-Adjudication-Category-submittedamount\"> </a></td><td>submitted amount</td><td/></tr><tr><td style=\"white-space:nowrap\">allowedamount<a name=\"CARIN-BB-Adjudication-Category-allowedamount\"> </a></td><td>allowed amount</td><td/></tr><tr><td style=\"white-space:nowrap\">deductibleamount<a name=\"CARIN-BB-Adjudication-Category-deductibleamount\"> </a></td><td>deductible amount</td><td/></tr><tr><td style=\"white-space:nowrap\">coinsuranceamount<a name=\"CARIN-BB-Adjudication-Category-coinsuranceamount\"> </a></td><td>coinsurance amount</td><td/></tr><tr><td style=\"white-space:nowrap\">copayamount<a name=\"CARIN-BB-Adjudication-Category-copayamount\"> </a></td><td>copay amount</td><td/></tr><tr><td style=\"white-space:nowrap\">noncoveredamount<a name=\"CARIN-BB-Adjudication-Category-noncoveredamount\"> </a></td><td>noncovered amount</td><td/></tr><tr><td style=\"white-space:nowrap\">cobamount<a name=\"CARIN-BB-Adjudication-Category-cobamount\"> </a></td><td>cob amount</td><td/></tr><tr><td style=\"white-space:nowrap\">paymentamount<a name=\"CARIN-BB-Adjudication-Category-paymentamount\"> </a></td><td>payment amount</td><td/></tr><tr><td style=\"white-space:nowrap\">patientpayamount<a name=\"CARIN-BB-Adjudication-Category-patientpayamount\"> </a></td><td>patient pay amount</td><td/></tr><tr><td style=\"white-space:nowrap\">denialreason<a name=\"CARIN-BB-Adjudication-Category-denialreason\"> </a></td><td>payment denial reason</td><td/></tr><tr><td style=\"white-space:nowrap\">innetworkbenefitpaymentstatus<a name=\"CARIN-BB-Adjudication-Category-innetworkbenefitpaymentstatus\"> </a></td><td>in network benefit payment status</td><td/></tr><tr><td style=\"white-space:nowrap\">outofnetworkbenefitpaymentstatus<a name=\"CARIN-BB-Adjudication-Category-outofnetworkbenefitpaymentstatus\"> </a></td><td>out of network benefit payment status</td><td/></tr><tr><td style=\"white-space:nowrap\">otherbenefitpaymentstatus<a name=\"CARIN-BB-Adjudication-Category-otherbenefitpaymentstatus\"> </a></td><td>other benefit payment status</td><td/></tr><tr><td style=\"white-space:nowrap\">allowedunits<a name=\"CARIN-BB-Adjudication-Category-allowedunits\"> </a></td><td>allowed units</td><td/></tr></table></div>"
},
"url" : "http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-adjudicationcategory",
"version" : "0.1.0",
"name" : "CARINBBAdjudicationCategory",
"title" : "CARIN Blue Button Claim Adjudication Category Code System",
"status" : "draft",
"date" : "2019-07-27T00:00:00+00:00",
"publisher" : "CARIN Alliance",
"caseSensitive" : true,
"content" : "complete",
"concept" : [
{
"code" : "benefitPaymentStatusCode",
"display" : "Benefit payment status code",
"definition" : "Benefit payment status code"
},
{
"code" : "paymentDenialCode",
"display" : "Payment denial code",
"definition" : "Payment Denial Code"
},
{
"code" : "submittedamount",
"display" : "submitted amount"
},
{
"code" : "allowedamount",
"display" : "allowed amount"
},
{
"code" : "deductibleamount",
"display" : "deductible amount"
},
{
"code" : "coinsuranceamount",
"display" : "coinsurance amount"
},
{
"code" : "copayamount",
"display" : "copay amount"
},
{
"code" : "noncoveredamount",
"display" : "noncovered amount"
},
{
"code" : "cobamount",
"display" : "cob amount"
},
{
"code" : "paymentamount",
"display" : "payment amount"
},
{
"code" : "patientpayamount",
"display" : "patient pay amount"
},
{
"code" : "denialreason",
"display" : "payment denial reason"
},
{
"code" : "innetworkbenefitpaymentstatus",
"display" : "in network benefit payment status"
},
{
"code" : "outofnetworkbenefitpaymentstatus",
"display" : "out of network benefit payment status"
},
{
"code" : "otherbenefitpaymentstatus",
"display" : "other benefit payment status"
},
{
"code" : "allowedunits",
"display" : "allowed units"
}
]
}
