Release 5 Draft Ballot

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Codesystem-claim-use.xml

Financial Management Work GroupMaturity Level: N/AStandards Status: Informative

Raw XML (canonical form + also see XML Format Specification)

Definition for Code System Use

<?xml version="1.0" encoding="UTF-8"?>

<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="claim-use"/> 
  <meta> 
    <lastUpdated value="2021-10-19T11:32:14.310+11:00"/> 
    <profile value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      
      
      <p> This code system http://hl7.org/fhir/claim-use 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">claim
            
            
            <a name="claim-use-claim"> </a> 
          
          
          </td> 
          
          
          <td> Claim</td> 
          
          
          <td> The treatment is complete and this represents a Claim for the services.</td> 
        
        
        </tr> 
        
        
        <tr> 
          
          
          <td style="white-space:nowrap">preauthorization
            
            
            <a name="claim-use-preauthorization"> </a> 
          
          
          </td> 
          
          
          <td> Preauthorization</td> 
          
          
          <td> The treatment is proposed and this represents a Pre-authorization for the services.</td> 
        
        
        </tr> 
        
        
        <tr> 
          
          
          <td style="white-space:nowrap">predetermination
            
            
            <a name="claim-use-predetermination"> </a> 
          
          
          </td> 
          
          
          <td> Predetermination</td> 
          
          
          <td> The treatment is proposed and this represents a Pre-determination for the services.</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="trial-use"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="2"/> 
  </extension> 
  <url value="http://hl7.org/fhir/claim-use"/> 
  <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:oid:2.16.840.1.113883.4.642.1.545"/> 
  </identifier> 
  <version value="4.6.0"/> 
  <name value="Use"/> 
  <title value="Use"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <date value="2021-01-05T10:01:24+11:00"/> 
  <publisher value="HL7 (FHIR Project)"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://hl7.org/fhir"/> 
    </telecom> 
    <telecom> 
      <system value="email"/> 
      <value value="fhir@lists.hl7.org"/> 
    </telecom> 
  </contact> 
  <description value="The purpose of the Claim: predetermination, preauthorization, claim."/> 
  <caseSensitive value="true"/> 
  <valueSet value="http://hl7.org/fhir/ValueSet/claim-use"/> 
  <content value="complete"/> 
  <concept> 
    <code value="claim"/> 
    <display value="Claim"/> 
    <definition value="The treatment is complete and this represents a Claim for the services."/> 
  </concept> 
  <concept> 
    <code value="preauthorization"/> 
    <display value="Preauthorization"/> 
    <definition value="The treatment is proposed and this represents a Pre-authorization for the services."/> 
  </concept> 
  <concept> 
    <code value="predetermination"/> 
    <display value="Predetermination"/> 
    <definition value="The treatment is proposed and this represents a Pre-determination for the services."/> 
  </concept> 
</CodeSystem> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.