HL7 Terminology (THO)
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This page is part of the HL7 Terminology (v5.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: Claim Type Codes - XML Representation

Draft as of 2024-03-09 Maturity Level: 2

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="claim-type"/>
  <meta>
    <lastUpdated value="2020-04-09T21:10:28.568+00:00"/>
    <profile
             value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p>This case-sensitive code system <code>http://terminology.hl7.org/CodeSystem/claim-type</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">institutional<a name="claim-type-institutional"> </a></td><td>Institutional</td><td>Hospital, clinic and typically inpatient claims.</td></tr><tr><td style="white-space:nowrap">oral<a name="claim-type-oral"> </a></td><td>Oral</td><td>Dental, Denture and Hygiene claims.</td></tr><tr><td style="white-space:nowrap">pharmacy<a name="claim-type-pharmacy"> </a></td><td>Pharmacy</td><td>Pharmacy claims for goods and services.</td></tr><tr><td style="white-space:nowrap">professional<a name="claim-type-professional"> </a></td><td>Professional</td><td>Typically, outpatient claims from Physician, Psychological, Chiropractor, Physiotherapy, Speech Pathology, rehabilitative, consulting.</td></tr><tr><td style="white-space:nowrap">vision<a name="claim-type-vision"> </a></td><td>Vision</td><td>Vision claims for professional services and products such as glasses and contact lenses.</td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fm"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="2"/>
  </extension>
  <url value="http://terminology.hl7.org/CodeSystem/claim-type"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.1.1156"/>
  </identifier>
  <version value="1.0.0"/>
  <name value="ClaimTypeCodes"/>
  <title value="Claim Type Codes"/>
  <status value="draft"/>
  <experimental value="false"/>
  <date value="2024-03-09T11:11:30-07:00"/>
  <publisher value="Health Level Seven International"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="hq@HL7.org"/>
    </telecom>
  </contact>
  <description value="This value set includes Claim Type codes."/>
  <copyright
             value="This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license"/>
  <caseSensitive value="true"/>
  <valueSet value="http://terminology.hl7.org/ValueSet/claim-type"/>
  <content value="complete"/>
  <concept>
    <code value="institutional"/>
    <display value="Institutional"/>
    <definition value="Hospital, clinic and typically inpatient claims."/>
  </concept>
  <concept>
    <code value="oral"/>
    <display value="Oral"/>
    <definition value="Dental, Denture and Hygiene claims."/>
  </concept>
  <concept>
    <code value="pharmacy"/>
    <display value="Pharmacy"/>
    <definition value="Pharmacy claims for goods and services."/>
  </concept>
  <concept>
    <code value="professional"/>
    <display value="Professional"/>
    <definition
                value="Typically, outpatient claims from Physician, Psychological, Chiropractor, Physiotherapy, Speech Pathology, rehabilitative, consulting."/>
  </concept>
  <concept>
    <code value="vision"/>
    <display value="Vision"/>
    <definition
                value="Vision claims for professional services and products such as glasses and contact lenses."/>
  </concept>
</CodeSystem>