{
  "resourceType": "CodeSystem",
  "id": "claim-decision",
  "meta": {
    "lastUpdated": "2023-03-26T15:21:02.749+11:00",
    "profile": [
      "http://hl7.org/fhir/StructureDefinition/shareablecodesystem"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This 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'.</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.</td></tr></table></div>"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fm"
    }
  ],
  "url": "http://hl7.org/fhir/claim-decision",
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.4.1896"
    }
  ],
  "version": "5.0.0",
  "name": "ClaimAdjudicationDecisionCodes",
  "title": "Claim Adjudication Decision Codes",
  "status": "active",
  "experimental": false,
  "publisher": "HL7 International",
  "description": "This value set provides Claim Adjudication Decision codes.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "copyright": "HL7 Inc.",
  "caseSensitive": true,
  "content": "complete",
  "concept": [
    {
      "code": "denied",
      "display": "Denied",
      "definition": "The claim, or individual services, are not approved for any payment. This may also be known as 'rejected'."
    },
    {
      "code": "approved",
      "display": "Approved",
      "definition": "The claim, or individual services, are approved as submitted."
    },
    {
      "code": "partial",
      "display": "Partial",
      "definition": "The claim, or individual services, are approved at an amount less than as submitted."
    },
    {
      "code": "pending",
      "display": "Pending",
      "definition": "The adjudication processing is not complete. This may be due to requiring manual review or receipt of additional information."
    }
  ]
}