| Package | hl7.fhir.us.davinci-pct |
| Resource Type | CodeSystem |
| Id | PCTAdjudication |
| FHIR Version | R4 |
| Source | http://hl7.org/fhir/us/davinci-pct/https://build.fhir.org/ig/HL7/davinci-pct/CodeSystem-PCTAdjudication.html |
| URL | http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudication |
| Version | 2.0.0-draft |
| Status | active |
| Date | 2025-08-04T03:55:43+00:00 |
| Name | PCTAdjudication |
| Title | PCT Adjudication Code System |
| Realm | us |
| Authority | hl7 |
| Description | Describes the various amount fields used when payers receive and adjudicate a claim. It complements the values defined in http://terminology.hl7.org/CodeSystem/adjudication. This CodeSystem is currently defined by this IG, but is anticipated to be temporary. The concepts within are expected to be moved in a future version to a more central terminology specification such as THO, which will result in a code system url change and possibly modified codes and definitions. |
| Copyright | This CodeSystem is not copyrighted. |
| Content | complete |
| ValueSet | |
| PCTAdjudicationVS | PCT Adjudication Value Set |
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: CodeSystem PCTAdjudication
This case-sensitive code system http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudication defines the following codes:
{
"resourceType": "CodeSystem",
"id": "PCTAdjudication",
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "fm"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "trial-use",
"_valueCode": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
"valueCanonical": "http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct"
}
]
}
}
],
"url": "http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudication",
"identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "urn:oid:2.16.840.1.113883.4.642.40.4.16.2"
}
],
"version": "2.0.0-draft",
"name": "PCTAdjudication",
"title": "PCT Adjudication Code System",
"status": "active",
"experimental": false,
"date": "2025-08-04T03:55:43+00:00",
"publisher": "HL7 International / Financial Management",
"contact": [
{
"name": "HL7 International / Financial Management",
"telecom": [
{
"system": "url",
"value": "http://www.hl7.org/Special/committees/fm"
},
{
"system": "email",
"value": "fmlists@lists.hl7.org"
}
]
}
],
"description": "Describes the various amount fields used when payers receive and adjudicate a claim. It complements the values defined in http://terminology.hl7.org/CodeSystem/adjudication. This CodeSystem is currently defined by this IG, but is anticipated to be temporary. The concepts within are expected to be moved in a future version to a more central terminology specification such as THO, which will result in a code system url change and possibly modified codes and definitions.",
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "US"
}
]
}
],
"copyright": "This CodeSystem is not copyrighted.",
"caseSensitive": true,
"content": "complete",
"count": 4,
"concept": [
{
"code": "coinsurance",
"display": "Co-insurance",
"definition": "The amount the insured individual pays, as a set percentage of the cost of covered medical services, as an out-of-pocket payment to the provider. Example: Insured pays 20% and the insurer pays 80%."
},
{
"code": "noncovered",
"display": "Noncovered",
"definition": "The portion of the cost of this service that was deemed not eligible by the insurer because the service or member was not covered by the subscriber contract."
},
{
"code": "memberliability",
"display": "Member liability",
"definition": "The amount of the member's liability."
},
{
"code": "discount",
"display": "Discount",
"definition": "The amount of the discount"
}
]
}