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Narrative

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Source1

{
  "resourceType": "CodeSystem",
  "id": "claim-decision",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "extension": [
        {
          "url": "packageId",
          "valueId": "hl7.fhir.uv.xver-r5.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://hl7.org/fhir/claim-decision",
  "version": "5.0.0",
  "name": "ClaimAdjudicationDecisionCodes",
  "title": "Claim Adjudication Decision Codes",
  "status": "active",
  "experimental": false,
  "date": "2025-09-13T16:55:28-04:00",
  "publisher": "Financial Management",
  "contact": [
    {
      "name": "Financial Management",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description": "This value set provides Claim Adjudication Decision codes.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "copyright": "HL7 Inc.",
  "caseSensitive": true,
  "content": "complete",
  "concept": [
    {
      "code": "denied",
      "display": "Denied",
      "definition": "The claim, or individual services, are not approved for any payment. This may also be known as 'rejected'."
    },
    {
      "code": "approved",
      "display": "Approved",
      "definition": "The claim, or individual services, are approved as submitted."
    },
    {
      "code": "partial",
      "display": "Partial",
      "definition": "The claim, or individual services, are approved at an amount less than as submitted."
    },
    {
      "code": "pending",
      "display": "Pending",
      "definition": "The adjudication processing is not complete. This may be due to requiring manual review or receipt of additional information."
    }
  ]
}