HL7 v2.5.1 Vocabulary
0.1.0 - ci-build

HL7 v2.5.1 Vocabulary, published by HL7/FO. 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/frankoemig/hl7.v2.terminology.v251/ and changes regularly. See the Directory of published versions

## CodeSystem: Reimbursement Action Code (2.5.1 - 1.0.0) (Experimental)

Official URL: http://terminology.hl7.org/v2plusvocab/CodeSystem/reimbursementAction | Version: 1.0.0
Active as of 2026-01-27 | Computable Name: ReimbursementAction
Other Identifiers: OID:2.16.840.1.113883.18.293
Copyright/Legal: HL7 Inc., 2026

Code specifying the action to be taken during reimbursement calculations. In the US, this field is defined by CMS or other regulatory agencies. Used in HL7 Version 2.x messaging in the GP2 segment.

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

- Hl7VSreimbursementActionCode

Properties

This code system defines the following properties for its concepts

Name | Code | URI | Type | Description
versionIntroduced | versionIntroduced | http://terminology.hl7.org/v2plusvocab/CodeSystem/Property#versionIntroduced | string | version when was this code introduced
versionDeprecated | versionDeprecated | http://terminology.hl7.org/v2plusvocab/CodeSystem/Property#versionDeprecated | string | version when was this code deprecated
status | status | http://hl7.org/fhir/concept-properties#status | code | A code that indicates the status of the concept. Typical values are active, experimental, deprecated, and retired
comment | comment | http://terminology.hl7.org/v2plusvocab/CodeSystem/Property#comment | string | A string that provides additional detail pertinent to the use or understanding of the concept
usage | usage | http://terminology.hl7.org/v2plusvocab/CodeSystem/Property#usage | string | usage notes for this code
modified | modified | http://terminology.hl7.org/v2plusvocab/CodeSystem/Property#modified | dateTime | date of last modification

Concepts

This case-sensitive code system `http://terminology.hl7.org/v2plusvocab/CodeSystem/reimbursementAction` defines the following codes:

Code | Display | Definition | versionIntroduced
0 | OCE line item denial or rejection is not ignored | OCE line item denial or rejection is not ignored | 2.4
1 | OCE line item denial or rejection is ignored | OCE line item denial or rejection is ignored | 2.4
2 | External line item denial. Line item is denied even if no OCE edits | External line item denial. Line item is denied even if no OCE edits | 2.4
3 | External line item rejection. Line item is rejected even if no OCE edits | External line item rejection. Line item is rejected even if no OCE edits | 2.4