Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

• Narrative Content
• XML
• JSON
• TTL

: PDex Adjudication Discriminator - JSON Representation

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{
  "resourceType" : "CodeSystem",
  "id" : "PDexAdjudicationDiscriminator",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem PDexAdjudicationDiscriminator</b></p><a name=\"PDexAdjudicationDiscriminator\"> </a><a name=\"hcPDexAdjudicationDiscriminator\"> </a><a name=\"PDexAdjudicationDiscriminator-en-US\"> </a><p>This case-insensitive code system <code>http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationDiscriminator</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\">allowedunits<a name=\"PDexAdjudicationDiscriminator-allowedunits\"> </a></td><td>allowed units</td><td>defines the adjudication slice to define allowed units</td></tr><tr><td style=\"white-space:nowrap\">consumedunits<a name=\"PDexAdjudicationDiscriminator-consumedunits\"> </a></td><td>consumed units</td><td>defines the adjudication slice to define consumed units</td></tr><tr><td style=\"white-space:nowrap\">denialreason<a name=\"PDexAdjudicationDiscriminator-denialreason\"> </a></td><td>Denial Reason</td><td>defines the adjudication slice to identify the denial reason</td></tr></table></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "trial-use",
      "_valueCode" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex"
          }
        ]
      }
    }
  ],
  "url" : "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexAdjudicationDiscriminator",
  "version" : "2.1.0",
  "name" : "PDexAdjudicationDiscriminator",
  "title" : "PDex Adjudication Discriminator",
  "status" : "active",
  "experimental" : false,
  "date" : "2024-12-13T18:03:36+00:00",
  "publisher" : "HL7 International / Financial Management",
  "contact" : [
    {
      "name" : "HL7 International / Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/fm"
        },
        {
          "system" : "email",
          "value" : "fm@lists.HL7.org"
        }
      ]
    },
    {
      "name" : "Mark Scrimshire (mark.scrimshire@onyxhealth.io)",
      "telecom" : [
        {
          "system" : "email",
          "value" : "mailto:mark.scrimshire@onyxhealth.io"
        }
      ]
    },
    {
      "name" : "HL7 International - Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description" : "Used as the discriminator for the data elements in adjudication and item.adjudication",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "copyright" : "This CodeSystem is not copyrighted.",
  "caseSensitive" : false,
  "content" : "complete",
  "count" : 3,
  "concept" : [
    {
      "code" : "allowedunits",
      "display" : "allowed units",
      "definition" : "defines the adjudication slice to define allowed units"
    },
    {
      "code" : "consumedunits",
      "display" : "consumed units",
      "definition" : "defines the adjudication slice to define consumed units"
    },
    {
      "code" : "denialreason",
      "display" : "Denial Reason",
      "definition" : "defines the adjudication slice to identify the denial reason"
    }
  ]
}