HL7 Terminology (THO)
6.0.2 - Publication International flag

This page is part of the HL7 Terminology (v6.0.2: Release) based on FHIR (HL7® FHIR® Standard) v5.0.0. This is the current published version. For a full list of available versions, see the Directory of published versions

: Claim Type Codes - JSON Representation

Active as of 2024-07-21 Maturity Level: 2

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{
  "resourceType" : "CodeSystem",
  "id" : "claim-type",
  "meta" : {
    "lastUpdated" : "2024-04-24T00:00:00+00:00",
    "profile" : [
      🔗 "http://hl7.org/fhir/StructureDefinition/shareablecodesystem"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem claim-type</b></p><a name=\"claim-type\"> </a><a name=\"hcclaim-type\"> </a><a name=\"claim-type-en-US\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Last updated: 2024-04-24 00:00:00+0000</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/R5/shareablecodesystem.html\">Shareable CodeSystem</a></p></div><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>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger" : 2
    }
  ],
  "url" : "http://terminology.hl7.org/CodeSystem/claim-type",
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.4.642.1.1156"
    }
  ],
  "version" : "1.0.1",
  "name" : "ClaimTypeCodes",
  "title" : "Claim Type Codes",
  "status" : "active",
  "experimental" : false,
  "date" : "2024-07-21T02:30:42-06:00",
  "publisher" : "Health Level Seven International",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://hl7.org"
        },
        {
          "system" : "email",
          "value" : "hq@HL7.org"
        }
      ]
    }
  ],
  "description" : "This value set includes Claim Type codes.",
  "copyright" : "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" : true,
  "valueSet" : "http://terminology.hl7.org/ValueSet/claim-type",
  "content" : "complete",
  "concept" : [
    {
      "code" : "institutional",
      "display" : "Institutional",
      "definition" : "Hospital, clinic and typically inpatient claims."
    },
    {
      "code" : "oral",
      "display" : "Oral",
      "definition" : "Dental, Denture and Hygiene claims."
    },
    {
      "code" : "pharmacy",
      "display" : "Pharmacy",
      "definition" : "Pharmacy claims for goods and services."
    },
    {
      "code" : "professional",
      "display" : "Professional",
      "definition" : "Typically, outpatient claims from Physician, Psychological, Chiropractor, Physiotherapy, Speech Pathology, rehabilitative, consulting."
    },
    {
      "code" : "vision",
      "display" : "Vision",
      "definition" : "Vision claims for professional services and products such as glasses and contact lenses."
    }
  ]
}