Consumer-Directed Payer Data Exchange
- Release 0.1.0

This page is part of a downloaded copy of this specification. This page is part of the CARIN Blue Button Implementation Guide (v0.1.0: STU1 Ballot 1) based on FHIR R4. For a full list of available versions, see the Directory of published versions

Turtle Format: CodeSystem-CARIN-BB-Adjudication-Category

Raw ttl

@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 -------------------------------------------------------------------

 a fhir:CodeSystem;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "CARIN-BB-Adjudication-Category"];
  fhir:Resource.meta [
     fhir:Meta.versionId [ fhir:value "4" ];
     fhir:Meta.lastUpdated [ fhir:value "2019-12-01T18:53:17.000+00:00"^^xsd:dateTime ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>CARIN Blue Button Claim Adjudication Category Code System</h2><p>This code system http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-adjudicationcategory 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\">benefitPaymentStatusCode<a name=\"CARIN-BB-Adjudication-Category-benefitPaymentStatusCode\"> </a></td><td>Benefit payment status code</td><td>Benefit payment status code</td></tr><tr><td style=\"white-space:nowrap\">paymentDenialCode<a name=\"CARIN-BB-Adjudication-Category-paymentDenialCode\"> </a></td><td>Payment denial code</td><td>Payment Denial Code</td></tr><tr><td style=\"white-space:nowrap\">submittedamount<a name=\"CARIN-BB-Adjudication-Category-submittedamount\"> </a></td><td>submitted amount</td><td/></tr><tr><td style=\"white-space:nowrap\">allowedamount<a name=\"CARIN-BB-Adjudication-Category-allowedamount\"> </a></td><td>allowed amount</td><td/></tr><tr><td style=\"white-space:nowrap\">deductibleamount<a name=\"CARIN-BB-Adjudication-Category-deductibleamount\"> </a></td><td>deductible amount</td><td/></tr><tr><td style=\"white-space:nowrap\">coinsuranceamount<a name=\"CARIN-BB-Adjudication-Category-coinsuranceamount\"> </a></td><td>coinsurance amount</td><td/></tr><tr><td style=\"white-space:nowrap\">copayamount<a name=\"CARIN-BB-Adjudication-Category-copayamount\"> </a></td><td>copay amount</td><td/></tr><tr><td style=\"white-space:nowrap\">noncoveredamount<a name=\"CARIN-BB-Adjudication-Category-noncoveredamount\"> </a></td><td>noncovered amount</td><td/></tr><tr><td style=\"white-space:nowrap\">cobamount<a name=\"CARIN-BB-Adjudication-Category-cobamount\"> </a></td><td>cob amount</td><td/></tr><tr><td style=\"white-space:nowrap\">paymentamount<a name=\"CARIN-BB-Adjudication-Category-paymentamount\"> </a></td><td>payment amount</td><td/></tr><tr><td style=\"white-space:nowrap\">patientpayamount<a name=\"CARIN-BB-Adjudication-Category-patientpayamount\"> </a></td><td>patient pay amount</td><td/></tr><tr><td style=\"white-space:nowrap\">denialreason<a name=\"CARIN-BB-Adjudication-Category-denialreason\"> </a></td><td>payment denial reason</td><td/></tr><tr><td style=\"white-space:nowrap\">innetworkbenefitpaymentstatus<a name=\"CARIN-BB-Adjudication-Category-innetworkbenefitpaymentstatus\"> </a></td><td>in network benefit payment status</td><td/></tr><tr><td style=\"white-space:nowrap\">outofnetworkbenefitpaymentstatus<a name=\"CARIN-BB-Adjudication-Category-outofnetworkbenefitpaymentstatus\"> </a></td><td>out of network benefit payment status</td><td/></tr><tr><td style=\"white-space:nowrap\">otherbenefitpaymentstatus<a name=\"CARIN-BB-Adjudication-Category-otherbenefitpaymentstatus\"> </a></td><td>other benefit payment status</td><td/></tr><tr><td style=\"white-space:nowrap\">allowedunits<a name=\"CARIN-BB-Adjudication-Category-allowedunits\"> </a></td><td>allowed units</td><td/></tr></table></div>"
  ];
  fhir:CodeSystem.url [ fhir:value "http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-adjudicationcategory"];
  fhir:CodeSystem.version [ fhir:value "0.1.0"];
  fhir:CodeSystem.name [ fhir:value "CARINBBAdjudicationCategory"];
  fhir:CodeSystem.title [ fhir:value "CARIN Blue Button Claim Adjudication Category Code System"];
  fhir:CodeSystem.status [ fhir:value "draft"];
  fhir:CodeSystem.date [ fhir:value "2019-07-27T00:00:00+00:00"^^xsd:dateTime];
  fhir:CodeSystem.publisher [ fhir:value "CARIN Alliance"];
  fhir:CodeSystem.caseSensitive [ fhir:value "true"^^xsd:boolean];
  fhir:CodeSystem.content [ fhir:value "complete"];
  fhir:CodeSystem.concept [
     fhir:index 0;
     fhir:CodeSystem.concept.code [ fhir:value "benefitPaymentStatusCode" ];
     fhir:CodeSystem.concept.display [ fhir:value "Benefit payment status code" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Benefit payment status code" ]
  ], [
     fhir:index 1;
     fhir:CodeSystem.concept.code [ fhir:value "paymentDenialCode" ];
     fhir:CodeSystem.concept.display [ fhir:value "Payment denial code" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Payment Denial Code" ]
  ], [
     fhir:index 2;
     fhir:CodeSystem.concept.code [ fhir:value "submittedamount" ];
     fhir:CodeSystem.concept.display [ fhir:value "submitted amount" ]
  ], [
     fhir:index 3;
     fhir:CodeSystem.concept.code [ fhir:value "allowedamount" ];
     fhir:CodeSystem.concept.display [ fhir:value "allowed amount" ]
  ], [
     fhir:index 4;
     fhir:CodeSystem.concept.code [ fhir:value "deductibleamount" ];
     fhir:CodeSystem.concept.display [ fhir:value "deductible amount" ]
  ], [
     fhir:index 5;
     fhir:CodeSystem.concept.code [ fhir:value "coinsuranceamount" ];
     fhir:CodeSystem.concept.display [ fhir:value "coinsurance amount" ]
  ], [
     fhir:index 6;
     fhir:CodeSystem.concept.code [ fhir:value "copayamount" ];
     fhir:CodeSystem.concept.display [ fhir:value "copay amount" ]
  ], [
     fhir:index 7;
     fhir:CodeSystem.concept.code [ fhir:value "noncoveredamount" ];
     fhir:CodeSystem.concept.display [ fhir:value "noncovered amount" ]
  ], [
     fhir:index 8;
     fhir:CodeSystem.concept.code [ fhir:value "cobamount" ];
     fhir:CodeSystem.concept.display [ fhir:value "cob amount" ]
  ], [
     fhir:index 9;
     fhir:CodeSystem.concept.code [ fhir:value "paymentamount" ];
     fhir:CodeSystem.concept.display [ fhir:value "payment amount" ]
  ], [
     fhir:index 10;
     fhir:CodeSystem.concept.code [ fhir:value "patientpayamount" ];
     fhir:CodeSystem.concept.display [ fhir:value "patient pay amount" ]
  ], [
     fhir:index 11;
     fhir:CodeSystem.concept.code [ fhir:value "denialreason" ];
     fhir:CodeSystem.concept.display [ fhir:value "payment denial reason" ]
  ], [
     fhir:index 12;
     fhir:CodeSystem.concept.code [ fhir:value "innetworkbenefitpaymentstatus" ];
     fhir:CodeSystem.concept.display [ fhir:value "in network benefit payment status" ]
  ], [
     fhir:index 13;
     fhir:CodeSystem.concept.code [ fhir:value "outofnetworkbenefitpaymentstatus" ];
     fhir:CodeSystem.concept.display [ fhir:value "out of network benefit payment status" ]
  ], [
     fhir:index 14;
     fhir:CodeSystem.concept.code [ fhir:value "otherbenefitpaymentstatus" ];
     fhir:CodeSystem.concept.display [ fhir:value "other benefit payment status" ]
  ], [
     fhir:index 15;
     fhir:CodeSystem.concept.code [ fhir:value "allowedunits" ];
     fhir:CodeSystem.concept.display [ fhir:value "allowed units" ]
  ].

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

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.