{
  "resourceType": "CodeSystem",
  "id": "claim-outcome",
  "meta": {
    "lastUpdated": "2026-05-20T15:02:53.575+00:00"
  },
  "text": {
    "status": "generated",
    "div": "\u003cdiv xmlns\u003d\"http://www.w3.org/1999/xhtml\"\u003e\u003cp class\u003d\"res-header-id\"\u003e\u003cb\u003eGenerated Narrative: CodeSystem claim-outcome\u003c/b\u003e\u003c/p\u003e\u003ca name\u003d\"claim-outcome\"\u003e \u003c/a\u003e\u003ca name\u003d\"hcclaim-outcome\"\u003e \u003c/a\u003e\u003cp\u003eThis case-sensitive code system \u003ccode\u003ehttp://hl7.org/fhir/claim-outcome\u003c/code\u003e defines the following codes:\u003c/p\u003e\u003ctable class\u003d\"codes\"\u003e\u003ctr\u003e\u003ctd style\u003d\"white-space:nowrap\"\u003e\u003cb\u003eCode\u003c/b\u003e\u003c/td\u003e\u003ctd\u003e\u003cb\u003eDisplay\u003c/b\u003e\u003c/td\u003e\u003ctd\u003e\u003cb\u003eDefinition\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd style\u003d\"white-space:nowrap\"\u003equeued\u003ca name\u003d\"claim-outcome-queued\"\u003e \u003c/a\u003e\u003c/td\u003e\u003ctd\u003eQueued\u003c/td\u003e\u003ctd\u003eThe Claim/Pre-authorization/Pre-determination has been received but processing has not begun.\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd style\u003d\"white-space:nowrap\"\u003ecomplete\u003ca name\u003d\"claim-outcome-complete\"\u003e \u003c/a\u003e\u003c/td\u003e\u003ctd\u003eProcessing Complete\u003c/td\u003e\u003ctd\u003eThe processing has completed without errors\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd style\u003d\"white-space:nowrap\"\u003eerror\u003ca name\u003d\"claim-outcome-error\"\u003e \u003c/a\u003e\u003c/td\u003e\u003ctd\u003eError\u003c/td\u003e\u003ctd\u003eOne or more errors have been detected in the Claim\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd style\u003d\"white-space:nowrap\"\u003epartial\u003ca name\u003d\"claim-outcome-partial\"\u003e \u003c/a\u003e\u003c/td\u003e\u003ctd\u003ePartial Processing\u003c/td\u003e\u003ctd\u003eNo errors have been detected in the Claim and some of the adjudication has been performed.\u003c/td\u003e\u003c/tr\u003e\u003c/table\u003e\u003c/div\u003e"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fm"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "normative"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 2
    }
  ],
  "url": "http://hl7.org/fhir/claim-outcome",
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.4.1897"
    }
  ],
  "version": "6.0.0-ballot4",
  "name": "ClaimProcessingOutcomeCodes",
  "title": "Claim Processing Outcome Codes",
  "status": "active",
  "experimental": false,
  "publisher": "HL7 International",
  "description": "This value set includes Claim Processing Outcome 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": "queued",
      "display": "Queued",
      "definition": "The Claim/Pre-authorization/Pre-determination has been received but processing has not begun."
    },
    {
      "code": "complete",
      "display": "Processing Complete",
      "definition": "The processing has completed without errors"
    },
    {
      "code": "error",
      "display": "Error",
      "definition": "One or more errors have been detected in the Claim"
    },
    {
      "code": "partial",
      "display": "Partial Processing",
      "definition": "No errors have been detected in the Claim and some of the adjudication has been performed."
    }
  ]
}