ClaimAdjudicationDecisionCodes

Claim Adjudication Decision Codes

activecomplete4 conceptsv5.0.0

This value set provides Claim Adjudication Decision codes.

Metadata

hl7.org/fhir
Canonical URL
http://hl7.org/fhir/claim-decision
ID
claim-decision
Version
5.0.0
Publisher
HL7 International
Case Sensitive
Yes
Copyright
HL7 Inc.
In the unified registry

Concepts (4)

denied
Denied
The claim, or individual services, are not approved for any payment. This may also be known as 'rejected'.
approved
Approved
The claim, or individual services, are approved as submitted.
partial
Partial
The claim, or individual services, are approved at an amount less than as submitted.
pending
Pending
The adjudication processing is not complete. This may be due to requiring manual review or receipt of additional information.