FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5
0.0.1-snapshot-2 - informative International flag

FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5 - Version 0.0.1-snapshot-2. See the Directory of published versions

CodeSystem: Claim Adjudication Decision Codes

Official URL: http://hl7.org/fhir/claim-decision Version: 5.0.0
Standards status: Informative Maturity Level: 0 Responsible: Financial Management Computable Name: ClaimAdjudicationDecisionCodes

Copyright/Legal: HL7 Inc.

This value set provides Claim Adjudication Decision codes.

This Code system is referenced in the content logical definition of the following value sets:

This case-sensitive code system http://hl7.org/fhir/claim-decision defines the following codes:

CodeDisplayDefinition
denied Denied The claim, or individual services, are not approved for any payment. This may also be known as 'rejected'.
approved Approved The claim, or individual services, are approved as submitted.
partial Partial The claim, or individual services, are approved at an amount less than as submitted.
pending Pending The adjudication processing is not complete. This may be due to requiring manual review or receipt of additional information.