Codesystem-adjudication.json

Definition for Code System Adjudication Value Codes

{
  "resourceType": "CodeSystem",
  "id": "adjudication",
  "meta": {
    "lastUpdated": "2018-04-03T12:05:46.262+10:00",
    "profile": [
      "http://hl7.org/fhir/StructureDefinition/shareablecodesystem"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<div>!-- Snipped for Brevity --></div>"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fm"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-ballot-status",
      "valueString": "Draft"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 1
    }
  ],
  "url": "http://hl7.org/fhir/adjudication",
  "identifier": {
    "system": "urn:ietf:rfc:3986",
    "value": "urn:oid:2.16.840.1.113883.4.642.1.597"
  },
  "version": "3.3.0",
  "name": "Adjudication Value Codes",
  "status": "draft",
  "experimental": true,
  "publisher": "FHIR Project team",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://hl7.org/fhir"
        }
      ]
    }
  ],
  "description": "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": "This is an example set.",
  "caseSensitive": true,
  "valueSet": "http://hl7.org/fhir/ValueSet/adjudication",
  "content": "complete",
  "concept": [
    {
      "code": "submitted",
      "display": "Submitted Amount",
      "definition": "The total submitted amount for the claim or group or line item."
    },
    {
      "code": "copay",
      "display": "CoPay",
      "definition": "Patient Co-Payment"
    },
    {
      "code": "eligible",
      "display": "Eligible Amount",
      "definition": "Amount of the change which is considered for adjudication."
    },
    {
      "code": "deductible",
      "display": "Deductable",
      "definition": "Amount deducted from the eligible amount prior to adjudication."
    },
    {
      "code": "unallocdeduct",
      "display": "Unallocated Deductable",
      "definition": "The amount of deductable which could not allocated to other line items."
    },
    {
      "code": "eligpercent",
      "display": "Eligible %",
      "definition": "Eligible Percentage."
    },
    {
      "code": "tax",
      "display": "Tax",
      "definition": "The amount of tax."
    },
    {
      "code": "benefit",
      "display": "Benefit Amount",
      "definition": "Amount payable under the coverage"
    }
  ]
}