HL7 Terminology (THO)
5.2.0 - Publication International flag

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

CodeSystem: overallClaimDisposition

Official URL: http://terminology.hl7.org/CodeSystem/v2-0457 Version: 2.1.0
Active as of 2019-12-01 Responsible: HL7, Inc Computable Name: OverallClaimDisposition
Other Identifiers: id: urn:oid:2.16.840.1.113883.18.292

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

Code system of concepts specifying the final status of the claim. Used in HL7 Version 2.x messaging in the GP1 segment.

Underlying Master Code System for V2 table 0457 (Overall Claim Disposition Code)

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

Properties

This code system defines the following properties for its concepts

CodeURITypeDescription
statushttp://terminology.hl7.org/CodeSystem/utg-concept-properties#statuscodeStatus of the concept
deprecatedhttp://terminology.hl7.org/CodeSystem/utg-concept-properties#v2-table-deprecatedcodeVersion of HL7 in which the code was deprecated

Concepts

This code system http://terminology.hl7.org/CodeSystem/v2-0457 defines the following codes:

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

History

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