R5ClaimDecisionReasonForR4

Cross-version ValueSet R5.ClaimAdjudicationDecisionReasonCodes for use in FHIR R4

activeExtensions for Using Data Elements from FHIR R5 in FHIR R40.1.05 concepts5 expanded

This cross-version ValueSet represents content from `http://hl7.org/fhir/ValueSet/claim-decision-reason|5.0.0` for use in FHIR R4.

Metadata

hl7.org/fhir
Canonical URL
http://hl7.org/fhir/uv/xver/ValueSet/R5-claim-decision-reason-for-R4
ID
R5-claim-decision-reason-for-R4
Name
R5ClaimDecisionReasonForR4

http://hl7.org/fhir/claim-decision-reason

5.0.05 codes
CodeDisplay
0001Not medically necessary
0002Prior authorization not obtained
0003Provider out-of-network
0004Service inconsistent with patient age
0005Benefit limits exceeded