HL7 Terminology
1.0.0 - Publication
HL7 Terminology
1.0.0 - Publication
This page is part of the HL7 Terminology (v1.0.0: Release) based on FHIR R4. The current version which supercedes this version is 5.2.0. For a full list of available versions, see the Directory of published versions 
Summary
| Defining URL: | http://terminology.hl7.org/ValueSet/adjudication |
| Version: | 4.1.0 |
| Name: | AdjudicationValueCodes |
| Status: | draft |
| Title: | Adjudication Value Codes |
| Definition: | 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. |
| Publisher: | FHIR Project team |
| Committee: | Financial Management |
| OID: | 2.16.840.1.113883.4.642.3.596 (for OID based terminology systems) |
| Copyright: | This is an example set. |
| Maturity: | 1 |
| Source Resource: | XML / JSON / Turtle |
References
This value set is not used
http://terminology.hl7.org/CodeSystem/adjudication
This value set contains 8 concepts
Expansion based on Adjudication Value Codes v4.2.0 (CodeSystem)
All codes from system http://terminology.hl7.org/CodeSystem/adjudication
| Code | Display | Definition |
| submitted | Submitted Amount | The total submitted amount for the claim or group or line item. |
| copay | CoPay | Patient Co-Payment |
| eligible | Eligible Amount | Amount of the change which is considered for adjudication. |
| deductible | Deductible | Amount deducted from the eligible amount prior to adjudication. |
| unallocdeduct | Unallocated Deductible | The amount of deductible which could not allocated to other line items. |
| eligpercent | Eligible % | Eligible Percentage. |
| tax | Tax | The amount of tax. |
| benefit | Benefit Amount | Amount payable under the coverage |
Explanation of the columns that may appear on this page:
| Level | A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies |
| Source | The source of the definition of the code (when the value set draws in codes defined elsewhere) |
| Code | The code (used as the code in the resource instance) |
| Display | The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application |
| Definition | An explanation of the meaning of the concept |
| Comments | Additional notes about how to use the code |
History
| Date | Action | Custodian | Author | Comment |
| 2020-05-06 | revise | Vocabulary WG | Ted Klein | Migrated to the UTG maintenance environment and publishing tooling. |
IG © 2020+ HL7 International - Vocabulary Work Group. Package hl7.terminology#1.0.0 based on FHIR 4.0.1. Generated 2020-05-09
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