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

ValueSet: hl7VS-overallClaimDispositionCode

Official URL: http://terminology.hl7.org/ValueSet/v2-0457 Version: 2.0.0
Active as of 2019-12-01 Responsible: HL7, Inc Computable Name: Hl7VSOverallClaimDispositionCode
Other Identifiers: : urn:oid:2.16.840.1.113883.21.308

Copyright/Legal: Copyright HL7. Licensed under creative commons public domain

Value Set of codes specifying the final status of the claim.

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

 

Expansion

This value set contains 5 concepts

Expansion based on overallClaimDisposition v2.1.0 (CodeSystem)

All codes in this table are from the system http://terminology.hl7.org/CodeSystem/v2-0457

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

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
System 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

DateActionCustodianAuthorComment
2020-05-06reviseVocabulary WGTed KleinMigrated to the UTG maintenance environment and publishing tooling.