This
page
is
part
of
the
FHIR
Specification
(v5.0.0:
R5
-
STU
v6.0.0-ballot1:
Release
6
Ballot
(1st
Draft)
(see
Ballot
Notes
).
This
is
the
The
current
published
version
in
it's
permanent
home
(it
will
always
be
available
at
this
URL).
is
5.0.0
.
For
a
full
list
of
available
versions,
see
the
Directory
of
published
versions
Example
CodeSystem/eligibility-outcome
(XML)
Raw
XML
(
canonical
form
+
also
see
XML
Format
Specification
)
Definition
for
Code
SystemClaimProcessingCodes
<?xml version="1.0" encoding="UTF-8"?>
<CodeSystem xmlns="http://hl7.org/fhir">
<id value="eligibility-outcome"/>
<meta>
<lastUpdated value="2023-12-18T15:12:07.602+11:00"/>
<profile value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
This code system
<p> This case-sensitive code system
<code> http://hl7.org/fhir/eligibility-outcome</code> defines the following codes:
</p>
<table class="codes">
<tr>
<td style="white-space:nowrap">
<b> Code</b>
</td>
<td>
<b> Display</b>
</td>
<td>
<b> Definition</b>
</td>
</tr>
<tr>
<td style="white-space:nowrap">queued
<a name="eligibility-outcome-queued"> </a>
</td>
<td> Queued</td>
<td> The Claim/Pre-authorization/Pre-determination has been received but processing
has not begun.</td>
</tr>
<tr>
<td style="white-space:nowrap">complete
<a name="eligibility-outcome-complete"> </a>
</td>
<td> Processing Complete</td>
<td> The processing has completed without errors</td>
</tr>
<tr>
<td style="white-space:nowrap">error
<a name="eligibility-outcome-error"> </a>
</td>
<td> Error</td>
<td> One or more errors have been detected in the Claim</td>
</tr>
<tr>
<td style="white-space:nowrap">partial
<a name="eligibility-outcome-partial"> </a>
</td>
<td> Partial Processing</td>
<td> No errors have been detected in the Claim and some of the adjudication has been
performed.</td>
</tr>
</table>
</div>
</text>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="fm"/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
<valueCode value="trial-use"/>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
<valueInteger value="2"/>
</extension>
<url value="http://hl7.org/fhir/eligibility-outcome"/>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:oid:2.16.840.1.113883.4.642.4.2072"/>
</identifier>
<version value="6.0.0-ballot1"/>
<name value="ClaimProcessingCodes"/>
<title value="Claim Processing Codes"/>
<status value="active"/>
<experimental value="false"/>
<publisher value="FHIR Project team"/>
<contact>
<telecom>
<system value="url"/>
<value value="http://hl7.org/fhir"/>
</telecom>
</contact>
<description value="This value set includes Claim Processing Outcome codes."/>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
<display value="World"/>
</coding>
</jurisdiction>
<copyright value="HL7 Inc."/>
<caseSensitive value="true"/>
<valueSet value="http://hl7.org/fhir/ValueSet/eligibility-outcome"/>
<content value="complete"/>
<concept>
<code value="queued"/>
<display value="Queued"/>
<definition value="The Claim/Pre-authorization/Pre-determination has been received but processing
has not begun."/>
</concept>
<concept>
<code value="complete"/>
<display value="Processing Complete"/>
<definition value="The processing has completed without errors"/>
</concept>
<concept>
<code value="error"/>
<display value="Error"/>
<definition value="One or more errors have been detected in the Claim"/>
</concept>
<concept>
<code value="partial"/>
<display value="Partial Processing"/>
<definition value="No errors have been detected in the Claim and some of the adjudication has been
performed."/>
</concept>
</
CodeSystem
>
Usage
note:
every
effort
has
been
made
to
ensure
that
the
examples
are
correct
and
useful,
but
they
are
not
a
normative
part
of
the
specification.