FHIR © HL7.org  |  Server Home  |  XIG Home  |  Server Source  |  FHIR  

FHIR IG Statistics: CodeSystem/PCTAdjudicationCategoryCS

Packagehl7.fhir.us.davinci-pct
TypeCodeSystem
IdPCTAdjudicationCategoryCS
FHIR VersionR4
Sourcehttp://hl7.org/fhir/us/davinci-pct/https://build.fhir.org/ig/HL7/davinci-pct/CodeSystem-PCTAdjudicationCategoryCS.html
URLhttp://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS
Version2.0.0-draft
Statusactive
Date2025-06-03T13:32:08+00:00
NamePCTAdjudicationCategoryCS
TitlePCT Adjudication Category CodeSystem
Realmus
Authorityhl7
DescriptionCodes indicating the type of adjudication information provided. 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.
Contentcomplete

Resources that use this resource

ValueSet
PCTAdjudicationCategoryVSPCT GFE Item Adjudication Value Set

Resources that this resource uses

No resources found


Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: CodeSystem PCTAdjudicationCategoryCS

This case-sensitive code system http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS defines the following codes:

CodeDisplayDefinition
billingnetworkstatus Billing Network StatusIndicates the Billing Provider network status in relation to the patient's coverage.
renderingnetworkstatus Rendering Network StatusIndicates the Rendering Provider network status in relation to the patient's coverage.
benefitpaymentstatus Benefit Payment StatusIndicates the in network or out of network payment status of the claim.
adjustmentreason Adjustment ReasonDefines the adjudication slice to identify the adjustment reason
medicalmanagement Medical ManagementDefines the adjudication slice to identify medical management
memberliability Member LiabilityDefines the adjudication slice to identify member liability

Source

{
  "resourceType": "CodeSystem",
  "id": "PCTAdjudicationCategoryCS",
  "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/PCTAdjudicationCategoryCS",
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.40.4.16.3"
    }
  ],
  "version": "2.0.0-draft",
  "name": "PCTAdjudicationCategoryCS",
  "title": "PCT Adjudication Category CodeSystem",
  "status": "active",
  "experimental": false,
  "date": "2025-06-03T13:32:08+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": "Codes indicating the type of adjudication information provided. 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"
        }
      ]
    }
  ],
  "caseSensitive": true,
  "content": "complete",
  "count": 6,
  "concept": [
    {
      "code": "billingnetworkstatus",
      "display": "Billing Network Status",
      "definition": "Indicates the Billing Provider network status in relation to the patient's coverage."
    },
    {
      "code": "renderingnetworkstatus",
      "display": "Rendering Network Status",
      "definition": "Indicates the Rendering Provider network status in relation to the patient's coverage."
    },
    {
      "code": "benefitpaymentstatus",
      "display": "Benefit Payment Status",
      "definition": "Indicates the in network or out of network payment status of the claim."
    },
    {
      "code": "adjustmentreason",
      "display": "Adjustment Reason",
      "definition": "Defines the adjudication slice to identify the adjustment reason"
    },
    {
      "code": "medicalmanagement",
      "display": "Medical Management",
      "definition": "Defines the adjudication slice to identify medical management"
    },
    {
      "code": "memberliability",
      "display": "Member Liability",
      "definition": "Defines the adjudication slice to identify member liability"
    }
  ]
}