Codesystem-adjudication.xml

Definition for Code System Adjudication Value Codes

<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="adjudication"/> 
  <meta> 
    <lastUpdated value="2017-12-20T15:52:34.818+11:00"/> 
    <profile value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      <h2> Adjudication Value Codes</h2> 
      <div> 
        <p> This value set includes a smattering of Adjudication Value codes which includes codes
           to indicate the amounts eligible under the plan, the amount of benefit, copays etc.</p> 

      </div> 
      <p> 
        <b> Copyright Statement:</b>  This is an example set.
      </p> 
      <p> This code system http://hl7.org/fhir/adjudication 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">total
            <a name="adjudication-total"> </a> 
          </td> 
          <td> Total</td> 
          <td> Total submitted</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">copay
            <a name="adjudication-copay"> </a> 
          </td> 
          <td> CoPay</td> 
          <td> Patient Co-Payment</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">eligible
            <a name="adjudication-eligible"> </a> 
          </td> 
          <td> Eligible Amount</td> 
          <td> Amount of the change which is considered for adjudication</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">deductible
            <a name="adjudication-deductible"> </a> 
          </td> 
          <td> Deductable</td> 
          <td> Amount deducted from the eligible amount prior to adjudication</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">eligpercent
            <a name="adjudication-eligpercent"> </a> 
          </td> 
          <td> Eligible %</td> 
          <td> Eligible Percentage</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">tax
            <a name="adjudication-tax"> </a> 
          </td> 
          <td> Emergency Department</td> 
          <td> Emergency Department</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">benefit
            <a name="adjudication-benefit"> </a> 
          </td> 
          <td> Benefit Amount</td> 
          <td> Amount payable under the coverage</td> 
        </tr> 
      </table> 
    </div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fm"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-ballot-status">
    <valueString value="Draft"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1"/> 
  </extension> 
  <url value="http://hl7.org/fhir/adjudication"/> 
  <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:oid:2.16.840.1.113883.4.642.1.597"/> 
  </identifier> 
  <version value="3.2.0"/> 
  <name value="Adjudication Value Codes"/> 
  <status value="draft"/> 
  <experimental value="true"/> 
  <publisher value="FHIR Project team"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://hl7.org/fhir"/> 
    </telecom> 
  </contact> 
  <description value="This value set includes a smattering of Adjudication Value codes which includes codes
   to indicate the amounts eligible under the plan, the amount of benefit, copays etc."/> 
  <copyright value="This is an example set."/> 
  <caseSensitive value="true"/> 
  <valueSet value="http://hl7.org/fhir/ValueSet/adjudication"/> 
  <content value="complete"/> 
  <concept> 
    <code value="total"/> 
    <display value="Total"/> 
    <definition value="Total submitted"/> 
  </concept> 
  <concept> 
    <code value="copay"/> 
    <display value="CoPay"/> 
    <definition value="Patient Co-Payment"/> 
  </concept> 
  <concept> 
    <code value="eligible"/> 
    <display value="Eligible Amount"/> 
    <definition value="Amount of the change which is considered for adjudication"/> 
  </concept> 
  <concept> 
    <code value="deductible"/> 
    <display value="Deductable"/> 
    <definition value="Amount deducted from the eligible amount prior to adjudication"/> 
  </concept> 
  <concept> 
    <code value="eligpercent"/> 
    <display value="Eligible %"/> 
    <definition value="Eligible Percentage"/> 
  </concept> 
  <concept> 
    <code value="tax"/> 
    <display value="Emergency Department"/> 
    <definition value="Emergency Department"/> 
  </concept> 
  <concept> 
    <code value="benefit"/> 
    <display value="Benefit Amount"/> 
    <definition value="Amount payable under the coverage"/> 
  </concept> 
</CodeSystem>