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

: overallClaimDisposition - XML Representation

Active as of 2019-12-01

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="v2-0457"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Properties</b></p><table class="grid"><tr><td><b>Code</b></td><td><b>URL</b></td><td><b>Type</b></td><td><b>Description</b></td></tr><tr><td>status</td><td>http://terminology.hl7.org/CodeSystem/utg-concept-properties#status</td><td>code</td><td>Status of the concept</td></tr><tr><td>deprecated</td><td>http://terminology.hl7.org/CodeSystem/utg-concept-properties#v2-table-deprecated</td><td>code</td><td>Version of HL7 in which the code was deprecated</td></tr></table><p>This code system http://terminology.hl7.org/CodeSystem/v2-0457 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">0<a name="v2-0457-0"> </a></td><td>No edits present on claim</td><td>No edits present on claim</td></tr><tr><td style="white-space:nowrap">1<a name="v2-0457-1"> </a></td><td>Only edits present are for line item denial or rejection</td><td>Only edits present are for line item denial or rejection</td></tr><tr><td style="white-space:nowrap">2<a name="v2-0457-2"> </a></td><td>Multiple-day claim with one or more days denied or rejected</td><td>Multiple-day claim with one or more days denied or rejected</td></tr><tr><td style="white-space:nowrap">3<a name="v2-0457-3"> </a></td><td>Claim denied, rejected, suspended or returned to provider with only post payment edits</td><td>Claim denied, rejected, suspended or returned to provider with only post payment edits</td></tr><tr><td style="white-space:nowrap">4<a name="v2-0457-4"> </a></td><td>Claim denied, rejected, suspended or returned to provider with only pre payment edits</td><td>Claim denied, rejected, suspended or returned to provider with only pre payment edits</td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fm"/>
  </extension>
  <url value="http://terminology.hl7.org/CodeSystem/v2-0457"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.18.292"/>
  </identifier>
  <version value="2.1.0"/>
  <name value="OverallClaimDisposition"/>
  <title value="overallClaimDisposition"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2019-12-01"/>
  <publisher value="HL7, Inc"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/"/>
    </telecom>
  </contact>
  <description
               value="Code system of concepts specifying the final status of the claim.  Used in HL7 Version 2.x messaging in the GP1 segment."/>
  <purpose
           value="Underlying Master Code System for V2 table 0457 (Overall Claim Disposition Code)"/>
  <copyright
             value="Copyright HL7. Licensed under creative commons public domain"/>
  <caseSensitive value="true"/>
  <valueSet value="http://terminology.hl7.org/ValueSet/v2-0457"/>
  <hierarchyMeaning value="is-a"/>
  <compositional value="false"/>
  <versionNeeded value="false"/>
  <content value="complete"/>
  <property>
    <code value="status"/>
    <uri
         value="http://terminology.hl7.org/CodeSystem/utg-concept-properties#status"/>
    <description value="Status of the concept"/>
    <type value="code"/>
  </property>
  <property>
    <code value="deprecated"/>
    <uri
         value="http://terminology.hl7.org/CodeSystem/utg-concept-properties#v2-table-deprecated"/>
    <description value="Version of HL7 in which the code was deprecated"/>
    <type value="code"/>
  </property>
  <concept id="4832">
    <code value="0"/>
    <display value="No edits present on claim"/>
    <definition value="No edits present on claim"/>
    <property>
      <code value="status"/>
      <valueCode value="A"/>
    </property>
  </concept>
  <concept id="4833">
    <code value="1"/>
    <display value="Only edits present are for line item denial or rejection"/>
    <definition value="Only edits present are for line item denial or rejection"/>
    <property>
      <code value="status"/>
      <valueCode value="A"/>
    </property>
  </concept>
  <concept id="4834">
    <code value="2"/>
    <display value="Multiple-day claim with one or more days denied or rejected"/>
    <definition
                value="Multiple-day claim with one or more days denied or rejected"/>
    <property>
      <code value="status"/>
      <valueCode value="A"/>
    </property>
  </concept>
  <concept id="4835">
    <code value="3"/>
    <display
             value="Claim denied, rejected, suspended or returned to provider with only post payment edits"/>
    <definition
                value="Claim denied, rejected, suspended or returned to provider with only post payment edits"/>
    <property>
      <code value="status"/>
      <valueCode value="A"/>
    </property>
  </concept>
  <concept id="4836">
    <code value="4"/>
    <display
             value="Claim denied, rejected, suspended or returned to provider with only pre payment edits"/>
    <definition
                value="Claim denied, rejected, suspended or returned to provider with only pre payment edits"/>
    <property>
      <code value="status"/>
      <valueCode value="A"/>
    </property>
  </concept>
</CodeSystem>