Patient Cost Transparency Implementation Guide
1.1.0 - STU 1 United States of America flag

This page is part of the Da Vinci Patient Cost Transparency Implementation Guide (v1.1.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

CodeSystem: PCT Adjudication Category CodeSystem

Official URL: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS Version: 1.1.0
Standards status: Trial-use Computable Name: PCTAdjudicationCategoryCS

Codes indicating the type of adjudication information provided.

This Code system is referenced in the content logical definition of the following value sets:

This case-sensitive code system http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS defines the following codes:

CodeDisplayDefinition
billingnetworkstatus Billing Network StatusIndicates the Billing Provider network status in relation to the patient's coverage.
renderingnetworkstatus Rendering Network StatusIndicates the Rendering Provider network status in relation to the patient's coverage.
benefitpaymentstatus Benefit Payment StatusIndicates the in network or out of network payment status of the claim.
adjustmentreason Adjustment ReasonDefines the adjudication slice to identify the adjustment reason
medicalmanagement Medical ManagementDefines the adjudication slice to identify medical management
memberliability Member LiabilityDefines the adjudication slice to identify member liability