Definition for Code SystemClaimAdjudicationDecisionCodes

@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

[a fhir:CodeSystem ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "claim-decision"] ; # 
  fhir:meta [
     fhir:lastUpdated [ fhir:v "2025-01-23T19:52:32.810+00:00"^^xsd:dateTime ] ;
     fhir:profile ( [
       fhir:v "http://hl7.org/fhir/StructureDefinition/shareablecodesystem"^^xsd:anyURI ;
       fhir:link <http://hl7.org/fhir/StructureDefinition/shareablecodesystem>
     ] )
  ] ; # 
  fhir:text [
     fhir:status [ fhir:v "generated" ] ;
     fhir:div "<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><a name=\"claim-decision-en-US\"> </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>"
  ] ; # 
  fhir:extension ( [
     fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ] ;
     fhir:value [ fhir:v "fm" ]
  ] ) ; # 
  fhir:url [ fhir:v "http://hl7.org/fhir/claim-decision"^^xsd:anyURI] ; # 
  fhir:identifier ( [
     fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ;
     fhir:value [ fhir:v "urn:oid:2.16.840.1.113883.4.642.4.1896" ]
  ] ) ; # 
  fhir:version [ fhir:v "6.0.0-ballot2"] ; # 
  fhir:name [ fhir:v "ClaimAdjudicationDecisionCodes"] ; # 
  fhir:title [ fhir:v "Claim Adjudication Decision Codes"] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:experimental [ fhir:v "false"^^xsd:boolean] ; # 
  fhir:publisher [ fhir:v "HL7 International"] ; # 
  fhir:description [ fhir:v "This value set provides Claim Adjudication Decision codes."] ; # 
  fhir:jurisdiction ( [
     fhir:coding ( [
       fhir:system [ fhir:v "http://unstats.un.org/unsd/methods/m49/m49.htm"^^xsd:anyURI ] ;
       fhir:code [ fhir:v "001" ] ;
       fhir:display [ fhir:v "World" ]
     ] )
  ] ) ; # 
  fhir:copyright [ fhir:v "HL7 Inc."] ; # 
  fhir:caseSensitive [ fhir:v "true"^^xsd:boolean] ; # 
  fhir:hierarchyMeaning [] ; # 
  fhir:content [ fhir:v "complete"] ; # 
  fhir:concept ( [
     fhir:code [ fhir:v "denied" ] ;
     fhir:display [ fhir:v "Denied" ] ;
     fhir:definition [ fhir:v "The claim, or individual services, are not approved for any payment. This may also be known as 'rejected'." ]
  ] [
     fhir:code [ fhir:v "approved" ] ;
     fhir:display [ fhir:v "Approved" ] ;
     fhir:definition [ fhir:v "The claim, or individual services, are approved as submitted." ]
  ] [
     fhir:code [ fhir:v "partial" ] ;
     fhir:display [ fhir:v "Partial" ] ;
     fhir:definition [ fhir:v "The claim, or individual services, are approved at an amount less than as submitted." ]
  ] [
     fhir:code [ fhir:v "pending" ] ;
     fhir:display [ fhir:v "Pending" ] ;
     fhir:definition [ fhir:v "The adjudication processing is not complete. This may be due to requiring manual review or receipt of additional information." ]
  ] )] . # 

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