PCTAdjudicationCategoryCS

PCT Adjudication Category CodeSystem

activeDa Vinci PCT2.0.1complete6 concepts

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.

Metadata

hl7.org/fhir
Canonical URL
http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS
ID
PCTAdjudicationCategoryCS
Version
2.0.1
Publisher
HL7 International / Financial Management
Case Sensitive
Yes

Concepts (6)

CodeDisplayDefinition
billingnetworkstatusBilling Network StatusIndicates the Billing Provider network status in relation to the patient's coverage.
renderingnetworkstatusRendering Network StatusIndicates the Rendering Provider network status in relation to the patient's coverage.
benefitpaymentstatusBenefit Payment StatusIndicates the in network or out of network payment status of the claim.
adjustmentreasonAdjustment ReasonDefines the adjudication slice to identify the adjustment reason
medicalmanagementMedical ManagementDefines the adjudication slice to identify medical management
memberliabilityMember LiabilityDefines the adjudication slice to identify member liability