Claim Adjudication Decision Codes

{
  "description" : "This value set provides Claim Adjudication Decision codes.",
  "meta" : {
    "lastUpdated" : "2023-03-26T15:21:02.749+11:00",
    "profile" : [ "http://hl7.org/fhir/StructureDefinition/shareablecodesystem" ]
  },
  "publisher" : "HL7 International",
  "jurisdiction" : [ {
    "coding" : [ {
      "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "code" : "001",
      "display" : "World"
    } ]
  } ],
  "content" : "complete",
  "property" : null,
  "name" : "ClaimAdjudicationDecisionCodes",
  "copyright" : "HL7 Inc.",
  "experimental" : false,
  "resourceType" : "CodeSystem",
  "title" : "Claim Adjudication Decision Codes",
  "extension" : [ {
    "valueCode" : "fm",
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"
  }, {
    "extension" : [ {
      "valueString" : "concept",
      "url" : "path"
    }, {
      "url" : "count",
      "valueInteger" : 4
    } ],
    "url" : "http://health-samurai.io/extensions/excised-data"
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    "url" : "http://health-samurai.io/extensions/source",
    "valueCode" : "db"
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  "status" : "active",
  "id" : "claim-decision",
  "url" : "http://hl7.org/fhir/claim-decision",
  "identifier" : [ {
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.4.1896"
  } ],
  "caseSensitive" : true,
  "version" : "5.0.0",
  "text" : {
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n            <p>This code system \n              <code>http://hl7.org/fhir/claim-decision</code> defines the following codes:\n            </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\">denied\n                  <a name=\"claim-decision-denied\"> </a>\n                </td>\n                <td>Denied</td>\n                <td>The claim, or individual services, are not approved for any payment. This may also be known as 'rejected'.</td>\n              </tr>\n              <tr>\n                <td style=\"white-space:nowrap\">approved\n                  <a name=\"claim-decision-approved\"> </a>\n                </td>\n                <td>Approved</td>\n                <td>The claim, or individual services, are approved as submitted.</td>\n              </tr>\n              <tr>\n                <td style=\"white-space:nowrap\">partial\n                  <a name=\"claim-decision-partial\"> </a>\n                </td>\n                <td>Partial</td>\n                <td>The claim, or individual services, are approved at an amount less than as submitted.</td>\n              </tr>\n              <tr>\n                <td style=\"white-space:nowrap\">pending\n                  <a name=\"claim-decision-pending\"> </a>\n                </td>\n                <td>Pending</td>\n                <td>The adjudication processing is not complete. This may be due to requiring manual review or receipt of additional information.</td>\n              </tr>\n            </table>\n          </div>",
    "status" : "generated"
  }
}