CodeSystem-PCTAdjudicationCategoryCS

Sourcehl7.fhir.us.davinci-pct#current:Patient Cost Transparency Implementation Guide (v4.0.1)
resourceTypeCodeSystem
idPCTAdjudicationCategoryCS
canonicalhttp://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS
version1.0.0
statusactive
publisherHL7 International - Financial Management Work Group
namePCTAdjudicationCategoryCS
titlePCT Adjudication Category CodeSystem
date2023-03-29T20:18:58+00:00
experimentalfalse
descriptionCodes indicating the type of adjudication information provided.
jurisdictionsus
caseSensitivetrue
contentcomplete
Usages

This case-sensitive code system http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS defines the following codes:

Code Display Definition
billingnetworkstatus Billing Network Status Indicates the Billing Provider network status in relation to the patient's coverage.
renderingnetworkstatus Rendering Network Status Indicates the Rendering Provider network status in relation to the patient's coverage.
benefitpaymentstatus Benefit Payment Status Indicates the in network or out of network payment status of the claim.
adjustmentreason Adjustment Reason Defines the adjudication slice to identify the adjustment reason
medicalmanagement Medical Management Defines the adjudication slice to identify medical management
memberliability Member Liability Defines the adjudication slice to identify member liability

Produced 08 Sep 2023