Adjudication Value Codes
draftContentcompleteURL
http://terminology.hl7.org/CodeSystem/adjudicationCopied!
Version4.0.1Copied!
PublisherFHIR Project teamDescriptionThis 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.
Concepts
Select a concept to view details
Adjudication Value Codes
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 Statement:
This is an example set.
This code system http://terminology.hl7.org/CodeSystem/adjudication defines the following codes:
{
"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.",
"meta" : {
"lastUpdated" : "2019-11-01T09:29:23.356+11:00",
"profile" : [ "http://hl7.org/fhir/StructureDefinition/shareablecodesystem" ]
},
"publisher" : "FHIR Project team",
"content" : "complete",
"property" : null,
"name" : "AdjudicationValueCodes",
"copyright" : "This is an example set.",
"experimental" : false,
"resourceType" : "CodeSystem",
"title" : "Adjudication Value Codes",
"extension" : [ {
"valueCode" : "fm",
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"
}, {
"valueCode" : "draft",
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"
}, {
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger" : 1
}, {
"extension" : [ {
"valueString" : "concept",
"url" : "path"
}, {
"url" : "count",
"valueInteger" : 8
} ],
"url" : "http://health-samurai.io/extensions/excised-data"
}, {
"url" : "http://health-samurai.io/extensions/source",
"valueCode" : "db"
} ],
"status" : "draft",
"id" : "bf4549ce-5ab8-4d60-a42a-b76c313904c0",
"valueSet" : "http://hl7.org/fhir/ValueSet/adjudication",
"url" : "http://terminology.hl7.org/CodeSystem/adjudication",
"identifier" : [ {
"system" : "urn:ietf:rfc:3986",
"value" : "urn:oid:2.16.840.1.113883.4.642.4.1171"
} ],
"caseSensitive" : true,
"version" : "4.0.1",
"contact" : [ {
"telecom" : [ {
"system" : "url",
"value" : "http://hl7.org/fhir"
} ]
} ],
"text" : {
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <h2>Adjudication Value Codes</h2>\n <div>\n <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>\n\n </div>\n <p>\n <b>Copyright Statement:</b>\n </p>\n <div>\n <p>This is an example set.</p>\n\n </div>\n <p>This code system http://terminology.hl7.org/CodeSystem/adjudication defines the following codes:</p>\n <table class=\"codes\">\n <tr>\n <td style=\"white-space:nowrap\">\n <b>Code</b>\n </td>\n <td>\n <b>Display</b>\n </td>\n <td>\n <b>Definition</b>\n </td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">submitted\n <a name=\"adjudication-submitted\"> </a>\n </td>\n <td>Submitted Amount</td>\n <td>The total submitted amount for the claim or group or line item.</td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">copay\n <a name=\"adjudication-copay\"> </a>\n </td>\n <td>CoPay</td>\n <td>Patient Co-Payment</td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">eligible\n <a name=\"adjudication-eligible\"> </a>\n </td>\n <td>Eligible Amount</td>\n <td>Amount of the change which is considered for adjudication.</td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">deductible\n <a name=\"adjudication-deductible\"> </a>\n </td>\n <td>Deductible</td>\n <td>Amount deducted from the eligible amount prior to adjudication.</td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">unallocdeduct\n <a name=\"adjudication-unallocdeduct\"> </a>\n </td>\n <td>Unallocated Deductible</td>\n <td>The amount of deductible which could not allocated to other line items.</td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">eligpercent\n <a name=\"adjudication-eligpercent\"> </a>\n </td>\n <td>Eligible %</td>\n <td>Eligible Percentage.</td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">tax\n <a name=\"adjudication-tax\"> </a>\n </td>\n <td>Tax</td>\n <td>The amount of tax.</td>\n </tr>\n <tr>\n <td style=\"white-space:nowrap\">benefit\n <a name=\"adjudication-benefit\"> </a>\n </td>\n <td>Benefit Amount</td>\n <td>Amount payable under the coverage</td>\n </tr>\n </table>\n </div>",
"status" : "generated"
}
}