This page is part of the FHIR Specification v6.0.0-ballot1: Release 6 Ballot (1st Draft) (see Ballot Notes). The current version is 5.0.0. For a full list of available versions, see the Directory of published versions
Definition for Code SystemClaimProcessingOutcomeCodes
{
"resourceType" : "CodeSystem",
"id" : "claim-outcome",
"meta" : {
"lastUpdated" : "2023-12-18T15:12:07.602+11:00",
"profile" : ["http://hl7.org/fhir/StructureDefinition/shareablecodesystem"]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This case-sensitive code system <code>http://hl7.org/fhir/claim-outcome</code> 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\">queued<a name=\"claim-outcome-queued\"> </a></td><td>Queued</td><td>The Claim/Pre-authorization/Pre-determination has been received but processing has not begun.</td></tr><tr><td style=\"white-space:nowrap\">complete<a name=\"claim-outcome-complete\"> </a></td><td>Processing Complete</td><td>The processing has completed without errors</td></tr><tr><td style=\"white-space:nowrap\">error<a name=\"claim-outcome-error\"> </a></td><td>Error</td><td>One or more errors have been detected in the Claim</td></tr><tr><td style=\"white-space:nowrap\">partial<a name=\"claim-outcome-partial\"> </a></td><td>Partial Processing</td><td>No errors have been detected in the Claim and some of the adjudication has been performed.</td></tr></table></div>"
},
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "fm"
}],
"url" : "http://hl7.org/fhir/claim-outcome",
"identifier" : [{
"system" : "urn:ietf:rfc:3986",
"value" : "urn:oid:2.16.840.1.113883.4.642.4.1897"
}],
"version" : "6.0.0-ballot1",
"name" : "ClaimProcessingOutcomeCodes",
"title" : "Claim Processing Outcome Codes",
"status" : "active",
"experimental" : false,
"publisher" : "HL7 International",
"description" : "This value set includes Claim Processing Outcome codes.",
"jurisdiction" : [{
"coding" : [{
"system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
"code" : "001",
"display" : "World"
}]
}],
"copyright" : "HL7 Inc.",
"caseSensitive" : true,
"content" : "complete",
"concept" : [{
"code" : "queued",
"display" : "Queued",
"definition" : "The Claim/Pre-authorization/Pre-determination has been received but processing has not begun."
},
{
"code" : "complete",
"display" : "Processing Complete",
"definition" : "The processing has completed without errors"
},
{
"code" : "error",
"display" : "Error",
"definition" : "One or more errors have been detected in the Claim"
},
{
"code" : "partial",
"display" : "Partial Processing",
"definition" : "No errors have been detected in the Claim and some of the adjudication has been performed."
}]
}
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.