{
  "description": "Describes the various amount fields used when payers receive and adjudicate a claim.  It complements the values defined in http://terminology.hl7.org/CodeSystem/adjudication. This CodeSystem is currently defined by this IG, but is anticipated to be temporary. The concepts within are expected to be moved in a future version to a more central terminology specification such as THO, which will result in a code system url change and possibly modified codes and definitions.",
  "_filename": "CodeSystem-PCTAdjudication.json",
  "package_name": "hl7.fhir.us.davinci-pct",
  "date": "2024-04-08T16:53:34+00:00",
  "publisher": "HL7 International / Financial Management",
  "jurisdiction": [ {
    "coding": [ {
      "code": "US",
      "system": "urn:iso:std:iso:3166"
    } ]
  } ],
  "content": "complete",
  "name": "PCTAdjudication",
  "copyright": "This CodeSystem is not copyrighted.",
  "type": null,
  "experimental": "false",
  "resourceType": "CodeSystem",
  "title": "PCT Adjudication Code System",
  "package_version": "2.0.0-ballot",
  "extension": [ {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode": "fm"
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode": "trial-use",
    "_valueCode": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical": "http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct"
      } ]
    }
  } ],
  "status": "active",
  "id": "c93e1fe3-6009-4342-b9bd-80553cf35df5",
  "kind": null,
  "count": 4,
  "url": "http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudication",
  "identifier": [ {
    "value": "urn:oid:2.16.840.1.113883.4.642.40.4.16.2",
    "system": "urn:ietf:rfc:3986"
  } ],
  "concept": [ {
    "code": "coinsurance",
    "display": "Co-insurance",
    "definition": "The amount the insured individual pays, as a set percentage of the cost of covered medical services, as an out-of-pocket payment to the provider. Example: Insured pays 20% and the insurer pays 80%."
  }, {
    "code": "noncovered",
    "display": "Noncovered",
    "definition": "The portion of the cost of this service that was deemed not eligible by the insurer because the service or member was not covered by the subscriber contract."
  }, {
    "code": "memberliability",
    "display": "Member liability",
    "definition": "The amount of the member's liability."
  }, {
    "code": "discount",
    "display": "Discount",
    "definition": "The amount of the discount"
  } ],
  "caseSensitive": true,
  "version": "2.0.0-ballot",
  "contact": [ {
    "name": "HL7 International / Financial Management",
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/fm",
      "system": "url"
    }, {
      "value": "fmlists@lists.hl7.org",
      "system": "email"
    } ]
  } ]
}