HL7 Terminology (THO)
3.1.0 - Publication International flag

This page is part of the HL7 Terminology (v3.1.0: 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

CodeSystem: Adjudication Value Codes

Official URL: http://terminology.hl7.org/CodeSystem/adjudication Version: 0.1.0
Standards status: Draft Maturity Level: 1 Responsible: FHIR Project team Computable Name: AdjudicationValueCodes
Other Identifiers: : urn:oid:2.16.840.1.113883.4.642.1.1171

Copyright/Legal: This is an example set.

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.

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

This code system http://terminology.hl7.org/CodeSystem/adjudication defines the following codes:

CodeDisplayDefinition
submitted Submitted AmountThe total submitted amount for the claim or group or line item.
copay CoPayPatient Co-Payment
eligible Eligible AmountAmount of the change which is considered for adjudication.
deductible DeductibleAmount deducted from the eligible amount prior to adjudication.
unallocdeduct Unallocated DeductibleThe amount of deductible which could not allocated to other line items.
eligpercent Eligible %Eligible Percentage.
tax TaxThe amount of tax.
benefit Benefit AmountAmount payable under the coverage

History

DateActionCustodianAuthorComment
2020-10-14reviseVocabulary WGGrahame GrieveReset Version after migration to UTG
2020-05-06reviseVocabulary WGTed KleinMigrated to the UTG maintenance environment and publishing tooling.