openIMIS FHIR R4 Implementation Guide - Local Development build (v1.0.0). See the Directory of published versions

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: Rejection Reasons (Claim) - JSON Representation

Active as of 2022-05-31

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{
  "resourceType" : "CodeSystem",
  "id" : "claim-rejection-reasons",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This code system https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/claim-rejection-reasons defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td></tr><tr><td style=\"white-space:nowrap\">-1<a name=\"claim-rejection-reasons--1\"> </a></td><td>REJECTED BY MEDICAL OFFICER</td></tr><tr><td style=\"white-space:nowrap\">0<a name=\"claim-rejection-reasons-0\"> </a></td><td>ACCEPTED</td></tr><tr><td style=\"white-space:nowrap\">1<a name=\"claim-rejection-reasons-1\"> </a></td><td>INVALID ITEM OR SERVICE</td></tr><tr><td style=\"white-space:nowrap\">2<a name=\"claim-rejection-reasons-2\"> </a></td><td>NOT IN PRICE LIST</td></tr><tr><td style=\"white-space:nowrap\">3<a name=\"claim-rejection-reasons-3\"> </a></td><td>NO PRODUCT FOUND</td></tr><tr><td style=\"white-space:nowrap\">4<a name=\"claim-rejection-reasons-4\"> </a></td><td>CATEGORY LIMITATION</td></tr><tr><td style=\"white-space:nowrap\">5<a name=\"claim-rejection-reasons-5\"> </a></td><td>FREQUENCY FAILURE</td></tr><tr><td style=\"white-space:nowrap\">6<a name=\"claim-rejection-reasons-6\"> </a></td><td>DUPLICATED</td></tr><tr><td style=\"white-space:nowrap\">7<a name=\"claim-rejection-reasons-7\"> </a></td><td>FAMILY</td></tr><tr><td style=\"white-space:nowrap\">8<a name=\"claim-rejection-reasons-8\"> </a></td><td>DIAGNOSIS NOT IN LIST</td></tr><tr><td style=\"white-space:nowrap\">9<a name=\"claim-rejection-reasons-9\"> </a></td><td>TARGET DATE</td></tr><tr><td style=\"white-space:nowrap\">10<a name=\"claim-rejection-reasons-10\"> </a></td><td>CARE TYPE</td></tr><tr><td style=\"white-space:nowrap\">11<a name=\"claim-rejection-reasons-11\"> </a></td><td>MAX HOSPITAL ADMISSIONS</td></tr><tr><td style=\"white-space:nowrap\">12<a name=\"claim-rejection-reasons-12\"> </a></td><td>MAX VISITS</td></tr><tr><td style=\"white-space:nowrap\">13<a name=\"claim-rejection-reasons-13\"> </a></td><td>MAX CONSULTATIONS</td></tr><tr><td style=\"white-space:nowrap\">14<a name=\"claim-rejection-reasons-14\"> </a></td><td>MAX SURGERIES</td></tr><tr><td style=\"white-space:nowrap\">15<a name=\"claim-rejection-reasons-15\"> </a></td><td>MAX DELIVERIES</td></tr><tr><td style=\"white-space:nowrap\">16<a name=\"claim-rejection-reasons-16\"> </a></td><td>QTY OVER LIMIT</td></tr><tr><td style=\"white-space:nowrap\">17<a name=\"claim-rejection-reasons-17\"> </a></td><td>WAITING PERIOD FAIL</td></tr><tr><td style=\"white-space:nowrap\">19<a name=\"claim-rejection-reasons-19\"> </a></td><td>MAX ANTENATAL</td></tr></table></div>"
  },
  "url" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/claim-rejection-reasons",
  "version" : "1.0.0",
  "name" : "ClaimRejectionReasonsCS",
  "title" : "Rejection Reasons (Claim)",
  "status" : "active",
  "date" : "2022-05-31T10:56:28+00:00",
  "publisher" : "openIMIS Initiative",
  "contact" : [
    {
      "name" : "openIMIS Initiative",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.openimis.org"
        }
      ]
    },
    {
      "name" : "Dragos Dobre",
      "telecom" : [
        {
          "system" : "email",
          "value" : "[email protected]",
          "use" : "work"
        }
      ]
    }
  ],
  "description" : "Indicates the rejection reason of an item from a Claim. \nValues limited by openIMIS.",
  "content" : "complete",
  "count" : 20,
  "concept" : [
    {
      "code" : "-1",
      "display" : "REJECTED BY MEDICAL OFFICER"
    },
    {
      "code" : "0",
      "display" : "ACCEPTED"
    },
    {
      "code" : "1",
      "display" : "INVALID ITEM OR SERVICE"
    },
    {
      "code" : "2",
      "display" : "NOT IN PRICE LIST"
    },
    {
      "code" : "3",
      "display" : "NO PRODUCT FOUND"
    },
    {
      "code" : "4",
      "display" : "CATEGORY LIMITATION"
    },
    {
      "code" : "5",
      "display" : "FREQUENCY FAILURE"
    },
    {
      "code" : "6",
      "display" : "DUPLICATED"
    },
    {
      "code" : "7",
      "display" : "FAMILY"
    },
    {
      "code" : "8",
      "display" : "DIAGNOSIS NOT IN LIST"
    },
    {
      "code" : "9",
      "display" : "TARGET DATE"
    },
    {
      "code" : "10",
      "display" : "CARE TYPE"
    },
    {
      "code" : "11",
      "display" : "MAX HOSPITAL ADMISSIONS"
    },
    {
      "code" : "12",
      "display" : "MAX VISITS"
    },
    {
      "code" : "13",
      "display" : "MAX CONSULTATIONS"
    },
    {
      "code" : "14",
      "display" : "MAX SURGERIES"
    },
    {
      "code" : "15",
      "display" : "MAX DELIVERIES"
    },
    {
      "code" : "16",
      "display" : "QTY OVER LIMIT"
    },
    {
      "code" : "17",
      "display" : "WAITING PERIOD FAIL"
    },
    {
      "code" : "19",
      "display" : "MAX ANTENATAL"
    }
  ]
}