HL7 Terminology (THO)
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This page is part of the HL7 Terminology (v5.2.0: Release) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: Claim Type Codes - JSON Representation

Draft as of 2023-07-17 Maturity Level: 2

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{
  "resourceType" : "CodeSystem",
  "id" : "claim-type",
  "meta" : {
    "lastUpdated" : "2020-04-09T21:10:28.568+00:00",
    "profile" : [
      "http://hl7.org/fhir/StructureDefinition/shareablecodesystem"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This code system <code>http://terminology.hl7.org/CodeSystem/claim-type</code> 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\">institutional<a name=\"claim-type-institutional\"> </a></td><td>Institutional</td><td>Hospital, clinic and typically inpatient claims.</td></tr><tr><td style=\"white-space:nowrap\">oral<a name=\"claim-type-oral\"> </a></td><td>Oral</td><td>Dental, Denture and Hygiene claims.</td></tr><tr><td style=\"white-space:nowrap\">pharmacy<a name=\"claim-type-pharmacy\"> </a></td><td>Pharmacy</td><td>Pharmacy claims for goods and services.</td></tr><tr><td style=\"white-space:nowrap\">professional<a name=\"claim-type-professional\"> </a></td><td>Professional</td><td>Typically, outpatient claims from Physician, Psychological, Chiropractor, Physiotherapy, Speech Pathology, rehabilitative, consulting.</td></tr><tr><td style=\"white-space:nowrap\">vision<a name=\"claim-type-vision\"> </a></td><td>Vision</td><td>Vision claims for professional services and products such as glasses and contact lenses.</td></tr></table></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger" : 2
    }
  ],
  "url" : "http://terminology.hl7.org/CodeSystem/claim-type",
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.4.642.1.1156"
    }
  ],
  "version" : "0.1.0",
  "name" : "ClaimTypeCodes",
  "title" : "Claim Type Codes",
  "status" : "draft",
  "experimental" : false,
  "date" : "2023-07-17T22:16:15-06:00",
  "publisher" : "Financial Management",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://hl7.org/fhir"
        }
      ]
    }
  ],
  "description" : "This value set includes Claim Type codes.",
  "copyright" : "HL7 Inc.",
  "caseSensitive" : true,
  "valueSet" : "http://terminology.hl7.org/ValueSet/claim-type",
  "content" : "complete",
  "concept" : [
    {
      "code" : "institutional",
      "display" : "Institutional",
      "definition" : "Hospital, clinic and typically inpatient claims."
    },
    {
      "code" : "oral",
      "display" : "Oral",
      "definition" : "Dental, Denture and Hygiene claims."
    },
    {
      "code" : "pharmacy",
      "display" : "Pharmacy",
      "definition" : "Pharmacy claims for goods and services."
    },
    {
      "code" : "professional",
      "display" : "Professional",
      "definition" : "Typically, outpatient claims from Physician, Psychological, Chiropractor, Physiotherapy, Speech Pathology, rehabilitative, consulting."
    },
    {
      "code" : "vision",
      "display" : "Vision",
      "definition" : "Vision claims for professional services and products such as glasses and contact lenses."
    }
  ]
}