CARIN Consumer Directed Payer Data Exchange
0.3.1 - STU1

CARIN Consumer Directed Payer Data Exchange, published by HL7 Financial Management Working Group. This is not an authorized publication; it is the continuous build for version 0.3.1). This version is based on the current content of and changes regularly. See the Directory of published versions

CodeSystem: Claim Adjudication Category


Defining URL:
Title:Claim Adjudication Category
Content:All the concepts defined by the code system are included in the code system resource

Values for EOB.item.adjudication.category and total.category

Publisher:HL7 Financial Management Working Group
Content Mode:Complete
Source Resource:XML / JSON / Turtle

This Code system is referenced in the content logical definition of the following value sets:

This code system defines the following codes:

benefitPaymentStatusCode Benefit payment status codeBenefit payment status code
paymentDenialCode Payment denial codePayment Denial Code
submittedamount submitted amountUndefined
allowedamount allowed amountUndefined
deductibleamount deductible amountUndefined
coinsuranceamount coinsurance amountUndefined
copayamount copay amountUndefined
noncoveredamount noncovered amountUndefined
cobamount cob amountUndefined
paymentamount payment amountUndefined
patientpayamount patient pay amountUndefined
denialreason payment denial reasonUndefined
innetworkbenefitpaymentstatus in network benefit payment statusUndefined
outofnetworkbenefitpaymentstatus out of network benefit payment statusUndefined
otherbenefitpaymentstatus other benefit payment statusUndefined
allowedunits allowed unitsUndefined
inoutnetwork In or Out of NetworkUndefined