Claim Processing Outcome Codes

• Official URL: http://hl7.org/fhir/claim-outcome
• Version: 6.0.0
• Status: active
• Name: ClaimProcessingOutcomeCodes
• Title: Claim Processing Outcome Codes
• Description: This value set includes Claim Processing Outcome codes.
• Case Sensitive: true
• Content: complete

Concepts

CodeSystem XML

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

<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="claim-outcome"/>
  <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-outcome"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.4.1897"/>
  </identifier>
  <version value="6.0.0"/>
  <name value="ClaimProcessingOutcomeCodes"/>
  <title value="Claim Processing Outcome Codes"/>
  <status value="active"/>
  <experimental value="false"/>
  <description value="This value set includes Claim Processing Outcome codes."/>
  <copyright value="HL7 Inc."/>
  <caseSensitive value="true"/>
  <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>