HL7.FHIR.US.DAVINCI-PCT\PCT Adjudication Category CodeSystem

Patient Cost Transparency Implementation Guide
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This page is part of the Da Vinci Patient Cost Transparency Implementation Guide (v1.0.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.0. 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: 1.0.0
Active as of 2023-03-30				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 code system http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS defines the following codes:

Code	Display	Definition
billingnetworkstatus	Billing Network Status	Indicates the Billing Provider network status in relation to the patient's coverage.
renderingnetworkstatus	Rendering Network Status	Indicates the Rendering Provider network status in relation to the patient's coverage.
benefitpaymentstatus	Benefit Payment Status	Indicates the in network or out of network payment status of the claim.
adjustmentreason	Adjustment Reason	Defines the adjudication slice to identify the adjustment reason
medicalmanagement	Medical Management	Defines the adjudication slice to identify medical management
memberliability	Member Liability	Defines the adjudication slice to identify member liability