This page is part of the FHIR Specification (v4.2.0: R5 Preview #1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R4B R4 R3
Financial Management Work Group | Maturity Level: N/A | Standards Status: Informative |
Raw JSON (canonical form + also see JSON Format Specification)
Definition for Code System AdjudicationValueCodes
{ "resourceType" : "CodeSystem", "id" : "adjudication", "meta" : { "lastUpdated" : "2019-12-31T21:03:40.621+11:00", "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-standards-status", "valueCode" : "draft" }, { "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm", "valueInteger" : 1 }], "url" : "http://terminology.hl7.org/CodeSystem/adjudication", "identifier" : [{ "system" : "urn:ietf:rfc:3986", "value" : "urn:oid:2.16.840.1.113883.4.642.1.1171" }], "version" : "4.2.0", "name" : "AdjudicationValueCodes", "title" : "Adjudication Value Codes", "status" : "draft", "experimental" : false, "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" : "Deductible", "definition" : "Amount deducted from the eligible amount prior to adjudication." }, { "code" : "unallocdeduct", "display" : "Unallocated Deductible", "definition" : "The amount of deductible 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" }] }
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.