FHIR R6 FM Incubator, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fm-incubator/ and changes regularly. See the Directory of published versions

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• TTL

: Claim Processing Codes - XML Representation

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="enrollment-outcome"/>
  <meta>
    <lastUpdated value="2020-12-28T16:55:11.085+11:00"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CodeSystem enrollment-outcome</b></p><a name="enrollment-outcome"> </a><a name="hcenrollment-outcome"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Last updated: 2020-12-28 16:55:11+1100</p></div><p>This case-sensitive code system <code>http://hl7.org/fhir/enrollment-outcome</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">queued<a name="enrollment-outcome-queued"> </a></td><td>Queued</td><td>The Claim/Pre-authorization/Pre-determination has been received but processing has not begun.</td></tr><tr><td style="white-space:nowrap">complete<a name="enrollment-outcome-complete"> </a></td><td>Processing Complete</td><td>The processing has completed without errors</td></tr><tr><td style="white-space:nowrap">error<a name="enrollment-outcome-error"> </a></td><td>Error</td><td>One or more errors have been detected in the Claim</td></tr><tr><td style="white-space:nowrap">partial<a name="enrollment-outcome-partial"> </a></td><td>Partial Processing</td><td>No errors have been detected in the Claim and some of the adjudication has been performed.</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/enrollment-outcome"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.4.1974"/>
  </identifier>
  <version value="0.1.0"/>
  <name value="ClaimProcessingCodes"/>
  <title value="Claim Processing Codes"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2026-05-28T22:07:38+00:00"/>
  <publisher value="HL7 International / Financial Management"/>
  <contact>
    <name value="HL7 International / Financial Management"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fm"/>
    </telecom>
  </contact>
  <description
               value="This value set includes Claim Processing Outcome codes."/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
      <display value="World"/>
    </coding>
  </jurisdiction>
  <copyright value="HL7 Inc."/>
  <caseSensitive value="true"/>
  <valueSet value="http://hl7.org/fhir/ValueSet/enrollment-outcome"/>
  <content value="complete"/>
  <concept>
    <code value="queued"/>
    <display value="Queued"/>
    <definition
                value="The Claim/Pre-authorization/Pre-determination has been received but processing has not begun."/>
  </concept>
  <concept>
    <code value="complete"/>
    <display value="Processing Complete"/>
    <definition value="The processing has completed without errors"/>
  </concept>
  <concept>
    <code value="error"/>
    <display value="Error"/>
    <definition value="One or more errors have been detected in the Claim"/>
  </concept>
  <concept>
    <code value="partial"/>
    <display value="Partial Processing"/>
    <definition
                value="No errors have been detected in the Claim and some of the adjudication has been performed."/>
  </concept>
</CodeSystem>