HL7 Terminology (THO)
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CodeSystem: overallClaimDisposition

Official URL: http://terminology.hl7.org/CodeSystem/v2-0457 Version: 2.0.0
Active as of 2019-12-01 Responsible: Health Level Seven International Computable Name: OverallClaimDisposition
Other Identifiers: OID:2.16.840.1.113883.18.292

Copyright/Legal: This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html

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:

Generated Narrative: CodeSystem v2-0457

Properties

This code system defines the following properties for its concepts

NameCodeURITypeDescription
status status http://terminology.hl7.org/CodeSystem/utg-concept-properties#status code Status of the concept
deprecated deprecated http://terminology.hl7.org/CodeSystem/utg-concept-properties#v2-table-deprecated code Version of HL7 in which the code was deprecated

Concepts

This case-sensitive code system http://terminology.hl7.org/CodeSystem/v2-0457 defines the following codes in a Is-A hierarchy:

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

History

DateActionAuthorCustodianComment
2023-11-14reviseMarc DuteauTSMGAdd standard copyright and contact to internal content; up-476
2020-05-06reviseTed KleinVocabulary WGMigrated to the UTG maintenance environment and publishing tooling.