Patient Cost Transparency Implementation Guide
1.0.0 - STU 1 United States of America flag

Patient Cost Transparency Implementation Guide, published by HL7 International - Financial Management Work Group. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

CodeSystem: PCT Adjudication Category CodeSystem

Official URL: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS Version: 1.0.0
Active as of 2023-03-29 Computable Name: PCTAdjudicationCategoryCS

Codes indicating the type of adjudication information provided.

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

This code system http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudicationCategoryCS defines the following codes:

CodeDisplayDefinition
billingnetworkstatus Billing Network StatusIndicates the Billing Provider network status in relation to the patient's coverage.
renderingnetworkstatus Rendering Network StatusIndicates the Rendering Provider network status in relation to the patient's coverage.
benefitpaymentstatus Benefit Payment StatusIndicates the in network or out of network payment status of the claim.
adjustmentreason Adjustment ReasonDefines the adjudication slice to identify the adjustment reason
medicalmanagement Medical ManagementDefines the adjudication slice to identify medical management
memberliability Member LiabilityDefines the adjudication slice to identify member liability