CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
2.0.0 - STU 2 US

This page is part of the CARIN Blue Button Implementation Guide (v2.0.0: STU 2) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: C4BB Adjudication Discriminator Code System - XML Representation

Active as of 2022-11-28

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="C4BBAdjudicationDiscriminator"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p>This code system <code>http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator</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">allowedunits<a name="C4BBAdjudicationDiscriminator-allowedunits"> </a></td><td>allowed units</td><td>defines the adjudication slice to define allowed units</td></tr><tr><td style="white-space:nowrap">adjustmentreason<a name="C4BBAdjudicationDiscriminator-adjustmentreason"> </a></td><td>Adjustment Reason</td><td>Defines the adjudication slice to identify the adjustment reason</td></tr><tr><td style="white-space:nowrap">rejectreason<a name="C4BBAdjudicationDiscriminator-rejectreason"> </a></td><td>Reject Reason</td><td>Defines the adjudication slice to identify the reject reason</td></tr><tr><td style="white-space:nowrap">billingnetworkstatus<a name="C4BBAdjudicationDiscriminator-billingnetworkstatus"> </a></td><td>Billing Network Status</td><td>Indicates the Billing Provider network status in relation to a patient's coverage as of the effective date of service or admission.</td></tr><tr><td style="white-space:nowrap">renderingnetworkstatus<a name="C4BBAdjudicationDiscriminator-renderingnetworkstatus"> </a></td><td>Rendering Network Status</td><td>Indicates the Rendering Provider network status in relation to a patient's coverage as of the effective date of service or admission.</td></tr><tr><td style="white-space:nowrap">benefitpaymentstatus<a name="C4BBAdjudicationDiscriminator-benefitpaymentstatus"> </a></td><td>Benefit Payment Status</td><td>Indicates the network payment status in relation to a patient's coverage as of the effective date of service or admission.</td></tr></table></div>
  </text>
  <url
       value="http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationDiscriminator"/>
  <version value="2.0.0"/>
  <name value="C4BBAdjudicationDiscriminator"/>
  <title value="C4BB Adjudication Discriminator Code System"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2022-11-28T15:29:06+00:00"/>
  <publisher value="HL7 Financial Management Working Group"/>
  <contact>
    <name value="HL7 Financial Management Working Group"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fm"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="fm@lists.HL7.org"/>
    </telecom>
  </contact>
  <description
               value="Used as the discriminator for the data elements in adjudication and item.adjudication.

This is a code system defined locally by the CARIN BlueButton IG. As this IG matures, it is expected that this CodeSystem will be migrated to THO (terminology.hl7.org). The current CodeSystem url should be considered temporary and subject to change in a future version."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <copyright value="This CodeSystem is not copyrighted."/>
  <caseSensitive value="true"/>
  <content value="complete"/>
  <count value="6"/>
  <concept>
    <code value="allowedunits"/>
    <display value="allowed units"/>
    <definition
                value="defines the adjudication slice to define allowed units"/>
  </concept>
  <concept>
    <code value="adjustmentreason"/>
    <display value="Adjustment Reason"/>
    <definition
                value="Defines the adjudication slice to identify the adjustment reason"/>
  </concept>
  <concept>
    <code value="rejectreason"/>
    <display value="Reject Reason"/>
    <definition
                value="Defines the adjudication slice to identify the reject reason"/>
  </concept>
  <concept>
    <code value="billingnetworkstatus"/>
    <display value="Billing Network Status"/>
    <definition
                value="Indicates the Billing Provider network status in relation to a patient's coverage as of the effective date of service or admission."/>
  </concept>
  <concept>
    <code value="renderingnetworkstatus"/>
    <display value="Rendering Network Status"/>
    <definition
                value="Indicates the Rendering Provider network status in relation to a patient's coverage as of the effective date of service or admission."/>
  </concept>
  <concept>
    <code value="benefitpaymentstatus"/>
    <display value="Benefit Payment Status"/>
    <definition
                value="Indicates the network payment status in relation to a patient's coverage as of the effective date of service or admission."/>
  </concept>
</CodeSystem>