Definition for Code SystemClaimAdjudicationDecisionCodes

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      This code system 
         defines the following codes:
      
      
        
          
            
          
          
            
          
          
            
          
        
        
          denied
            
          
          

<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="claim-decision"/> 
  <meta> 
    <lastUpdated value="2025-04-01T12:16:37.966+11:00"/> 
    <profile value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p class="res-header-id">
        <b> Generated Narrative: CodeSystem claim-decision</b> 
      </p> 
      <a name="claim-decision"> </a> 
      <a name="hcclaim-decision"> </a> 
      <a name="claim-decision-en-AU"> </a> 
      <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border:
       1px solid #8da1b4; border-radius: 5px; line-height: 60%">
        <p style="margin-bottom: 0px"/>         <p style="margin-bottom: 0px">Profile:           <a href="shareablecodesystem.html">Shareable CodeSystem</a>         </p>       </div>       <p> This case-sensitive code system         <code> http://hl7.org/fhir/claim-decision</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">denied            <a name="claim-decision-denied"> </a>           </td>           <td> Denied</td> 
          <td> The claim, or individual services, are not approved for any payment. This may also
             be known as 'rejected'.
        
        
          approved
            
          
          
          
        
        
          partial
            
          
          
          
        
        
          pending
            
          
          

             be known as 'rejected'.</td> 
        </tr>         <tr>           <td style="white-space:nowrap">approved            <a name="claim-decision-approved"> </a>           </td>           <td> Approved</td>           <td> The claim, or individual services, are approved as submitted.</td>         </tr>         <tr>           <td style="white-space:nowrap">partial            <a name="claim-decision-partial"> </a>           </td>           <td> Partial</td>           <td> The claim, or individual services, are approved at an amount less than as submitted.</td>         </tr>         <tr>           <td style="white-space:nowrap">pending            <a name="claim-decision-pending"> </a>           </td>           <td> Pending</td> 
          <td> The adjudication processing is not complete. This may be due to requiring manual
             review or receipt of additional information.
        
      
    
  
  
    
  
  
  
    
    
  
  
  
  
  
  
  
  
  
    
      
      
      
    
  
  
  
  
  
    
    

             review or receipt of additional information.</td> 
        </tr>       </table>     </div>   </text>   <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">    <valueCode value="fm"/>   </extension>   <url value="http://hl7.org/fhir/claim-decision"/>   <identifier>     <system value="urn:ietf:rfc:3986"/>     <value value="urn:oid:2.16.840.1.113883.4.642.4.1896"/>   </identifier>   <version value="6.0.0-ballot3"/>   <name value="ClaimAdjudicationDecisionCodes"/>   <title value="Claim Adjudication Decision Codes"/>   <status value="active"/>   <experimental value="false"/>   <publisher value="HL7 International"/>   <description value="This value set provides Claim Adjudication Decision 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"/>   <content value="complete"/>   <concept>     <code value="denied"/>     <display value="Denied"/> 
    <definition value="The claim, or individual services, are not approved for any payment. This may also
     be known as 'rejected'.
  
  
    
    
    
  
  
    
    
    
  
  
    
    

     be known as 'rejected'."/> 
  </concept>   <concept>     <code value="approved"/>     <display value="Approved"/>     <definition value="The claim, or individual services, are approved as submitted."/>   </concept>   <concept>     <code value="partial"/>     <display value="Partial"/>     <definition value="The claim, or individual services, are approved at an amount less than as submitted."/>   </concept>   <concept>     <code value="pending"/>     <display value="Pending"/> 
    <definition value="The adjudication processing is not complete. This may be due to requiring manual
     review or receipt of additional information.
  

     review or receipt of additional information."/> 
  </concept> 


</

CodeSystem

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