Kenya Patient Summary Implementation Guide
0.1.0 - ci-build Kenya flag

Kenya Patient Summary Implementation Guide, published by Digital Health Agency (DHA), Kenya. 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/IntelliSOFT-Consulting/Kenya-Patient-Summary-FHIR-IG/ and changes regularly. See the Directory of published versions

: KNHTS.CLMS CodeSystem for claim status - TTL Representation

Draft as of 2026-08-07

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/knhts-clm-sts-cs> a fhir:CodeSystem ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "knhts-clm-sts-cs"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem knhts-clm-sts-cs</b></p><a name=\"knhts-clm-sts-cs\"> </a><a name=\"hcknhts-clm-sts-cs\"> </a><p>This case-insensitive code system <code>https://fhir.dha.go.ke/ig/patient-summary/CodeSystem/knhts-clm-sts-cs</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\">STS01<a name=\"knhts-clm-sts-cs-STS01\"> </a></td><td>NEW</td><td>Active</td></tr><tr><td style=\"white-space:nowrap\">STS02<a name=\"knhts-clm-sts-cs-STS02\"> </a></td><td>NOTIFIED</td><td>Identification done and payor notified</td></tr><tr><td style=\"white-space:nowrap\">STS03<a name=\"knhts-clm-sts-cs-STS03\"> </a></td><td>PREAUTHORIZED</td><td>Pre-authorization done.*</td></tr><tr><td style=\"white-space:nowrap\">STS04<a name=\"knhts-clm-sts-cs-STS04\"> </a></td><td>COMPLETE</td><td>Provider has checked that all requirements are met and the claim is ready for submission. Done at the end of a visit / after discharge.</td></tr><tr><td style=\"white-space:nowrap\">STS05<a name=\"knhts-clm-sts-cs-STS05\"> </a></td><td>CANCELLED</td><td>Cancelled at provider, before submission.</td></tr><tr><td style=\"white-space:nowrap\">STS06<a name=\"knhts-clm-sts-cs-STS06\"> </a></td><td>SUBMITTED</td><td>Submitted to payer.</td></tr><tr><td style=\"white-space:nowrap\">STS07<a name=\"knhts-clm-sts-cs-STS07\"> </a></td><td>RECEIVED</td><td>Received at payer.</td></tr><tr><td style=\"white-space:nowrap\">STS08<a name=\"knhts-clm-sts-cs-STS08\"> </a></td><td>APPROVED</td><td>Approved</td></tr><tr><td style=\"white-space:nowrap\">STS09<a name=\"knhts-clm-sts-cs-STS09\"> </a></td><td>REJECTED</td><td>The payer has indicated that the claim will not be paid.</td></tr><tr><td style=\"white-space:nowrap\">STS10<a name=\"knhts-clm-sts-cs-STS10\"> </a></td><td>PAID</td><td>The claim has been paid and the payee should expect to receive or have received  a remittance.</td></tr><tr><td style=\"white-space:nowrap\">STS11<a name=\"knhts-clm-sts-cs-STS11\"> </a></td><td>EXPIRED</td><td>Expired</td></tr><tr><td style=\"white-space:nowrap\">STS12<a name=\"knhts-clm-sts-cs-STS12\"> </a></td><td>QA</td><td>The claim is undergoing review.</td></tr></table></div>"
  ] ;
  fhir:CodeSystem.url [ fhir:value "https://fhir.dha.go.ke/ig/patient-summary/CodeSystem/knhts-clm-sts-cs"] ;
  fhir:CodeSystem.version [ fhir:value "0.1.0"] ;
  fhir:CodeSystem.name [ fhir:value "KNHTS_CLMS"] ;
  fhir:CodeSystem.title [ fhir:value "KNHTS.CLMS CodeSystem for claim status"] ;
  fhir:CodeSystem.status [ fhir:value "draft"] ;
  fhir:CodeSystem.experimental [ fhir:value "false"^^xsd:boolean] ;
  fhir:CodeSystem.date [ fhir:value "2026-08-07T13:10:11+00:00"^^xsd:dateTime] ;
  fhir:CodeSystem.publisher [ fhir:value "Digital Health Agency (DHA), Kenya"] ;
  fhir:CodeSystem.contact [
     fhir:index 0 ;
     fhir:ContactDetail.name [ fhir:value "Digital Health Agency (DHA), Kenya" ] ;
     fhir:ContactDetail.telecom [
       fhir:index 0 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "https://www.dha.go.ke" ]
     ], [
       fhir:index 1 ;
       fhir:ContactPoint.system [ fhir:value "email" ] ;
       fhir:ContactPoint.value [ fhir:value "interoperability@dha.go.ke" ]
     ]
  ], [
     fhir:index 1 ;
     fhir:ContactDetail.name [ fhir:value "Digital Health Agency of Kenya – Interoperability Team" ] ;
     fhir:ContactDetail.telecom [
       fhir:index 0 ;
       fhir:ContactPoint.system [ fhir:value "email" ] ;
       fhir:ContactPoint.value [ fhir:value "interoperability@dha.go.ke" ] ;
       fhir:ContactPoint.use [ fhir:value "work" ]
     ], [
       fhir:index 1 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "https://www.dha.go.ke" ] ;
       fhir:ContactPoint.use [ fhir:value "work" ]
     ]
  ] ;
  fhir:CodeSystem.description [ fhir:value "CodeSystem for KNHTS Claim status"] ;
  fhir:CodeSystem.jurisdiction [
     fhir:index 0 ;
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ] ;
       fhir:Coding.code [ fhir:value "KE" ] ;
       fhir:Coding.display [ fhir:value "Kenya" ]
     ]
  ] ;
  fhir:CodeSystem.copyright [ fhir:value "Copyright © 2024+ Digital Health Agency of Kenya. This content is licensed under Creative Commons Zero v1.0 Universal (CC0 1.0). No rights reserved.\n"] ;
  fhir:CodeSystem.caseSensitive [ fhir:value "false"^^xsd:boolean] ;
  fhir:CodeSystem.content [ fhir:value "complete"] ;
  fhir:CodeSystem.count [ fhir:value "12"^^xsd:nonNegativeInteger] ;
  fhir:CodeSystem.concept [
     fhir:index 0 ;
     fhir:CodeSystem.concept.code [ fhir:value "STS01" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "NEW" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Active" ]
  ], [
     fhir:index 1 ;
     fhir:CodeSystem.concept.code [ fhir:value "STS02" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "NOTIFIED" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Identification done and payor notified" ]
  ], [
     fhir:index 2 ;
     fhir:CodeSystem.concept.code [ fhir:value "STS03" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "PREAUTHORIZED" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Pre-authorization done.*" ]
  ], [
     fhir:index 3 ;
     fhir:CodeSystem.concept.code [ fhir:value "STS04" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "COMPLETE" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Provider has checked that all requirements are met and the claim is ready for submission. Done at the end of a visit / after discharge." ]
  ], [
     fhir:index 4 ;
     fhir:CodeSystem.concept.code [ fhir:value "STS05" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "CANCELLED" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Cancelled at provider, before submission." ]
  ], [
     fhir:index 5 ;
     fhir:CodeSystem.concept.code [ fhir:value "STS06" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "SUBMITTED" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Submitted to payer." ]
  ], [
     fhir:index 6 ;
     fhir:CodeSystem.concept.code [ fhir:value "STS07" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "RECEIVED" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Received at payer." ]
  ], [
     fhir:index 7 ;
     fhir:CodeSystem.concept.code [ fhir:value "STS08" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "APPROVED" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Approved" ]
  ], [
     fhir:index 8 ;
     fhir:CodeSystem.concept.code [ fhir:value "STS09" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "REJECTED" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The payer has indicated that the claim will not be paid." ]
  ], [
     fhir:index 9 ;
     fhir:CodeSystem.concept.code [ fhir:value "STS10" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "PAID" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The claim has been paid and the payee should expect to receive or have received  a remittance." ]
  ], [
     fhir:index 10 ;
     fhir:CodeSystem.concept.code [ fhir:value "STS11" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "EXPIRED" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Expired" ]
  ], [
     fhir:index 11 ;
     fhir:CodeSystem.concept.code [ fhir:value "STS12" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "QA" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The claim is undergoing review." ]
  ] .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/knhts-clm-sts-cs.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/CodeSystem/knhts-clm-sts-cs.ttl> .