HL7 Terminology (THO)
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CodeSystem: overallClaimDisposition

Official URL: http://terminology.hl7.org/CodeSystem/v2-0457 Version: 2.0.0
Active as of 2019-12-01 Responsible: Health Level Seven International Computable Name: OverallClaimDisposition
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:oid:2.16.840.1.113883.18.292

Copyright/Legal: 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

Code system of concepts specifying the final status of the claim. Used in HL7 Version 2.x messaging in the GP1 segment.

Underlying Master Code System for V2 table 0457 (Overall Claim Disposition Code)

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

Properties

This code system defines the following properties for its concepts

CodeURITypeDescription
statushttp://terminology.hl7.org/CodeSystem/utg-concept-properties#statuscodeStatus of the concept
deprecatedhttp://terminology.hl7.org/CodeSystem/utg-concept-properties#v2-table-deprecatedcodeVersion of HL7 in which the code was deprecated

Concepts

This case-sensitive code system http://terminology.hl7.org/CodeSystem/v2-0457 defines the following codes in a Is-A heirarchy:

CodeDisplayDefinition
0 No edits present on claimNo edits present on claim
1 Only edits present are for line item denial or rejectionOnly edits present are for line item denial or rejection
2 Multiple-day claim with one or more days denied or rejectedMultiple-day claim with one or more days denied or rejected
3 Claim denied, rejected, suspended or returned to provider with only post payment editsClaim denied, rejected, suspended or returned to provider with only post payment edits
4 Claim denied, rejected, suspended or returned to provider with only pre payment editsClaim denied, rejected, suspended or returned to provider with only pre payment edits

History

DateActionCustodianAuthorComment
2023-11-14reviseTSMGMarc DuteauAdd standard copyright and contact to internal content; up-476
2020-05-06reviseVocabulary WGTed KleinMigrated to the UTG maintenance environment and publishing tooling.