<?xml version="1.0" encoding="UTF-8"?><CodeSystem xmlns="http://hl7.org/fhir"><id value="claim-decision"/><meta><lastUpdated value="2026-03-31T20:34:10.183+00:00"/></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><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'.</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></text><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-ballot4"/><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'."/></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>