---
type: "codesystem"
title: "Claim Adjudication Decision Codes"
codesystem: "claim-decision"
---
# Claim Adjudication Decision Codes

- **Official URL**: http://hl7.org/fhir/claim-decision
- **Version**: 6.0.0
- **Status**: active
- **Name**: ClaimAdjudicationDecisionCodes
- **Title**: Claim Adjudication Decision Codes
- **Description**: This value set provides Claim Adjudication Decision codes.
- **Case Sensitive**: true
- **Content**: complete

## Concepts

| Code | Display | Definition |
| --- | --- | --- |
| 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. |

## CodeSystem XML



```xml
<?xml version="1.0" encoding="UTF-8"?>

<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="claim-decision"/>
  <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="normative"/>
  </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"/>
  <name value="ClaimAdjudicationDecisionCodes"/>
  <title value="Claim Adjudication Decision Codes"/>
  <status value="active"/>
  <experimental value="false"/>
  <description value="This value set provides Claim Adjudication Decision codes."/>
  <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'."/>
  </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."/>
  </concept>
</CodeSystem>
```