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: Reimbursement Action Code (2.4 - 1.0.0) (Experimental)

Official URL: http://terminology.hl7.org/v2plusvocab/CodeSystem/reimbursementActionV100 Version: 1.0.0
Active as of 2025-08-05 Computable Name: ReimbursementActionV100
Other Identifiers: OID:2.16.840.1.113883.18.293

Copyright/Legal: HL7 Inc., 2024

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:

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
version deprecated 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, to suppress IG-publisher warning, to be replaced with standard later 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/reimbursementActionV100 defines the following codes:

CodeDisplayDefinitionversion introduced
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