FHIR © HL7.org  |  FHIRsmith 4.0.1  |  Server Home  |  XIG Home  |  XIG Stats  | 

FHIR IG analytics

Packagehl7.fhir.uv.xver-r4b.r4.r4b
Resource TypeCodeSystem
IdCodeSystem-adjudication.json
FHIR VersionR4B

Resources that use this resource

No resources found

Resources that this resource uses

No resources found

Narrative

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

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

Code Display Definition
submitted Submitted Amount The total submitted amount for the claim or group or line item.
copay CoPay Patient Co-Payment
eligible Eligible Amount Amount of the change which is considered for adjudication.
deductible Deductible Amount deducted from the eligible amount prior to adjudication.
unallocdeduct Unallocated Deductible The amount of deductible which could not allocated to other line items.
eligpercent Eligible % Eligible Percentage.
tax Tax The amount of tax.
benefit Benefit Amount Amount payable under the coverage

Source1

{
  "resourceType": "CodeSystem",
  "id": "adjudication",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "extension": [
        {
          "url": "packageId",
          "valueId": "hl7.fhir.uv.xver-r4b.r4"
        },
        {
          "url": "version",
          "valueString": "0.0.1-snapshot-2"
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/package-source"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fm"
    }
  ],
  "url": "http://terminology.hl7.org/CodeSystem/adjudication",
  "version": "4.3.0",
  "name": "AdjudicationCodes",
  "title": "Adjudication Codes",
  "status": "draft",
  "experimental": false,
  "date": "2025-09-13T16:38:45-04:00",
  "publisher": "Financial Management",
  "contact": [
    {
      "name": "Financial Management",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description": "This value set includes a smattering of Adjudication codes.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "copyright": "This is an example set.",
  "caseSensitive": true,
  "content": "complete",
  "concept": [
    {
      "code": "submitted",
      "display": "Submitted Amount",
      "definition": "The total submitted amount for the claim or group or line item."
    },
    {
      "code": "copay",
      "display": "CoPay",
      "definition": "Patient Co-Payment"
    },
    {
      "code": "eligible",
      "display": "Eligible Amount",
      "definition": "Amount of the change which is considered for adjudication."
    },
    {
      "code": "deductible",
      "display": "Deductible",
      "definition": "Amount deducted from the eligible amount prior to adjudication."
    },
    {
      "code": "unallocdeduct",
      "display": "Unallocated Deductible",
      "definition": "The amount of deductible which could not allocated to other line items."
    },
    {
      "code": "eligpercent",
      "display": "Eligible %",
      "definition": "Eligible Percentage."
    },
    {
      "code": "tax",
      "display": "Tax",
      "definition": "The amount of tax."
    },
    {
      "code": "benefit",
      "display": "Benefit Amount",
      "definition": "Amount payable under the coverage"
    }
  ]
}