HL7 Terminology
1.0.0 - Publication

This page is part of the HL7 Terminology (v1.0.0: Release) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Adjudication Value Codes

Summary

Defining URL:http://terminology.hl7.org/CodeSystem/adjudication
Version:4.2.0
Name:AdjudicationValueCodes
Title:Adjudication Value Codes
Status:draft
Content:All the concepts defined by the code system are included in the code system resource
Definition:

This value set includes a smattering of Adjudication Value codes which includes codes to indicate the amounts eligible under the plan, the amount of benefit, copays etc.

Publisher:FHIR Project team
Committee:Financial Management
OID:2.16.840.1.113883.4.642.1.1171 (for OID based terminology systems)
Content Mode:Complete
Value Set:http://terminology.hl7.org/ValueSet/adjudication ( is the value set for all codes in this code system)
Copyright:

This is an example set.

Maturity:1
Source Resource:XML / JSON / Turtle

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

Adjudication Value Codes

This value set includes a smattering of Adjudication Value codes which includes codes to indicate the amounts eligible under the plan, the amount of benefit, copays etc.

Copyright Statement: This is an example set.

This code system http://terminology.hl7.org/CodeSystem/adjudication defines the following codes:

CodeDisplayDefinition
submitted Submitted AmountThe total submitted amount for the claim or group or line item.
copay CoPayPatient Co-Payment
eligible Eligible AmountAmount of the change which is considered for adjudication.
deductible DeductibleAmount deducted from the eligible amount prior to adjudication.
unallocdeduct Unallocated DeductibleThe amount of deductible which could not allocated to other line items.
eligpercent Eligible %Eligible Percentage.
tax TaxThe amount of tax.
benefit Benefit AmountAmount payable under the coverage

History

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