Consumer-Directed Payer Data Exchange
- Release 0.1.0

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

JSON Format: ValueSet-CARIN-BB-Adjudication-Category

Raw json

{
  "resourceType" : "ValueSet",
  "id" : "CARIN-BB-Adjudication-Category",
  "meta" : {
    "versionId" : "5",
    "lastUpdated" : "2019-11-30T09:17:00.000+00:00"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>CARIN Blue Button Claim Adjudication Category Value Set</h2><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in <a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html\"><code>http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-adjudicationcategory</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-benefitPaymentStatusCode\">benefitPaymentStatusCode</a></td><td>Benefit payment status code</td><td>Benefit payment status code</td></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-paymentDenialCode\">paymentDenialCode</a></td><td>Payment denial code</td><td>Payment Denial Code</td></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-submittedamount\">submittedamount</a></td><td>submitted amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-allowedamount\">allowedamount</a></td><td>allowed amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-deductibleamount\">deductibleamount</a></td><td>deductible amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-coinsuranceamount\">coinsuranceamount</a></td><td>coinsurance amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-copayamount\">copayamount</a></td><td>copay amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-noncoveredamount\">noncoveredamount</a></td><td>noncovered amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-cobamount\">cobamount</a></td><td>cob amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-paymentamount\">paymentamount</a></td><td>payment amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-patientpayamount\">patientpayamount</a></td><td>patient pay amount</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-denialreason\">denialreason</a></td><td>payment denial reason</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-innetworkbenefitpaymentstatus\">innetworkbenefitpaymentstatus</a></td><td>in network benefit payment status</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-outofnetworkbenefitpaymentstatus\">outofnetworkbenefitpaymentstatus</a></td><td>out of network benefit payment status</td><td/></tr><tr><td><a href=\"CodeSystem-CARIN-BB-Adjudication-Category.html#CARIN-BB-Adjudication-Category-otherbenefitpaymentstatus\">otherbenefitpaymentstatus</a></td><td>other benefit payment status</td><td/></tr></table></li></ul></div>"
  },
  "url" : "http://hl7.org/fhir/us/carin/ValueSet/carin-bb-adjudicationcategory",
  "version" : "0.1.0",
  "name" : "CARINBBAdjudicationCategory",
  "title" : "CARIN Blue Button Claim Adjudication Category Value Set",
  "status" : "draft",
  "date" : "2019-12-23T19:40:59+00:00",
  "compose" : {
    "include" : [
      {
        "system" : "http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-adjudicationcategory",
        "concept" : [
          {
            "code" : "benefitPaymentStatusCode",
            "display" : "Benefit payment status code"
          },
          {
            "code" : "paymentDenialCode",
            "display" : "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"
          }
        ]
      }
    ]
  }
}