v2+ Vocabulary
0.3.0 - Working Draft to present the concept ideas (FO)

v2+ Vocabulary - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

CodeSystem: Overall Claim Disposition Code (2.4 - 1.0.0) (Experimental)

Official URL: http://terminology.hl7.org/v2plusvocab/CodeSystem/OverallClaimDispositionV100 Version: 1.0.0
Active as of 2025-03-06 Computable Name: OverallClaimDispositionV100
Other Identifiers: http://hl7.org/oid#urn:oid:2.16.840.1.113883.18.292

Copyright/Legal: HL7 Inc., 2024

Code system of concepts specifying the final status of the claim. Used in HL7 Version 2.x messaging in the GP1 segment.

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

Generated Narrative: CodeSystem OverallClaimDispositionV100

Properties

This code system defines the following properties for its concepts

NameCodeURITypeDescription
version introduced 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 current status of this code
comment comment http://hl7.org/fhir/concept-properties#comment string further comment on this code
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/OverallClaimDispositionV100 defines the following codes:

CodeDisplayDefinitionversion introduced
0 No edits present on claim No edits present on claim 2.4
1 Only edits present are for line item denial or rejection Only edits present are for line item denial or rejection 2.4
2 Multiple-day claim with one or more days denied or rejected Multiple-day claim with one or more days denied or rejected 2.4
3 Claim denied, rejected, suspended or returned to provider with only post payment edits Claim denied, rejected, suspended or returned to provider with only post payment edits 2.4
4 Claim denied, rejected, suspended or returned to provider with only pre payment edits Claim denied, rejected, suspended or returned to provider with only pre payment edits 2.4