HL7 Terminology (THO)
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This page is part of the HL7 Terminology (v5.3.0: 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: paymentAdjustmentInformation

Official URL: http://terminology.hl7.org/CodeSystem/v2-0468 Version: 2.1.0
Active as of 2019-12-01 Responsible: HL7, Inc Computable Name: PaymentAdjustmentInformation
Other Identifiers: id: urn:oid:2.16.840.1.113883.18.297

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

Code system of concepts specifying any payment adjustment due to drugs or medical devices. Used in HL7 Version 2.x messaging in the GP2 segment.

Underlying Master Code System for V2 table 0468 (Payment Adjustment 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 case-sensitive code system http://terminology.hl7.org/CodeSystem/v2-0468 defines the following codes in a Is-A heirarchy:

CodeDisplayDefinition
1 No payment adjustmentNo payment adjustment
2 Designated current drug or biological payment adjustment applies to APC (status indicator G)Designated current drug or biological payment adjustment applies to APC (status indicator G)
3 Designated new device payment adjustment applies to APC (status indicator H)Designated new device payment adjustment applies to APC (status indicator H)
4 Designated new drug or new biological payment adjustment applies to APC (status indicator J)Designated new drug or new biological payment adjustment applies to APC (status indicator J)
5 Deductible not applicable (specific list of HCPCS codes)Deductible not applicable (specific list of HCPCS codes)

History

DateActionAuthorCustodianComment
2020-05-06reviseTed KleinVocabulary WGMigrated to the UTG maintenance environment and publishing tooling.