This page is part of the CARIN Blue Button Implementation Guide (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions 
| Defining URL: | http://hl7.org/fhir/us/carin/ValueSet/carin-bb-adjudicationcategory |
| Version: | 0.1.0 |
| Name: | CARINBBAdjudicationCategory |
| Status: | draft |
| Title: | CARIN Blue Button Claim Adjudication Category Value Set |
| Source Resource: | XML / JSON / Turtle |
- CARIN Blue Button Explanation of Benefit Inpatient Facility Profile
- CARIN Blue Button Explanation of Benefit Professional or Non-Clinician Profile
CARIN Blue Button Claim Adjudication Category Value Set
This value set includes codes from the following code systems:
- Include these codes as defined in
http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-adjudicationcategoryCode Display benefitPaymentStatusCode Benefit payment status code Benefit payment status code paymentDenialCode Payment denial code Payment Denial Code submittedamount submitted amount allowedamount allowed amount deductibleamount deductible amount coinsuranceamount coinsurance amount copayamount copay amount noncoveredamount noncovered amount cobamount cob amount paymentamount payment amount patientpayamount patient pay amount denialreason payment denial reason innetworkbenefitpaymentstatus in network benefit payment status outofnetworkbenefitpaymentstatus out of network benefit payment status otherbenefitpaymentstatus other benefit payment status
Expansion
This value set contains 15 concepts
Expansion based on http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-adjudicationcategory version 0.1.0
All codes from system http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-adjudicationcategory
| Code | Display | Definition |
| benefitPaymentStatusCode | Benefit payment status code | Benefit payment status code |
| paymentDenialCode | Payment denial code | Payment Denial Code |
| submittedamount | submitted amount | |
| allowedamount | allowed amount | |
| deductibleamount | deductible amount | |
| coinsuranceamount | coinsurance amount | |
| copayamount | copay amount | |
| noncoveredamount | noncovered amount | |
| cobamount | cob amount | |
| paymentamount | payment amount | |
| patientpayamount | patient pay amount | |
| denialreason | payment denial reason | |
| innetworkbenefitpaymentstatus | in network benefit payment status | |
| outofnetworkbenefitpaymentstatus | out of network benefit payment status | |
| otherbenefitpaymentstatus | other benefit payment status |
