{2 16 840 1 113883 11 21041}
Categories of contractual, policy, benefit, or administrative bases used by a payer when adjudicating a healthcare claim and determining the allowed, paid, or adjusted amounts. These codes include categories that describe why a claim line or claim total was adjudicated as it was, rather than the result of the adjudication.
Status in source: active.
Names: ClaimAdjudicationBasisCategories, claim-adjudication-basis-categories
{
"url": "http://terminology.hl7.org/ValueSet/claim-adjudication-basis-categories",
"date": "2026-06-12T00:00:00+00:00",
"title": "Claim Adjudication Basis Categories",
"status": "active",
"contact": [
{
"telecom": [
{
"value": "http://hl7.org",
"system": "url"
},
{
"value": "hq@HL7.org",
"system": "email"
}
]
}
],
"version": "1.0.0",
"copyright": "This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html",
"publisher": "Health Level Seven International",
"experimental": false,
"resource_type": "ValueSet",
"oid_identifier": {
"value": "urn:oid:2.16.840.1.113883.11.21041",
"system": "urn:ietf:rfc:3986"
}
}Downloaded: 2026-10-19T20:26:54.046133+00:00.
| OID | Name | Direct children | Descendants | Description |
|---|---|---|---|---|
| 2.16.840.1.113883.11.1 | administrativeGender, AdministrativeGender | 0 | 0 | |
| 2.16.840.1.113883.11.8 | acknowledgementType, AcknowledgementType | 0 | 0 | |
| 2.16.840.1.113883.11.12 | 12 | 1 | 1 | |
| 2.16.840.1.113883.11.20 | 20, SDWGExternalValueSetRootOID | 13 | 16 | |
| 2.16.840.1.113883.11.22 | ips-valueSetRoot | 0 | 0 | |
| 2.16.840.1.113883.11.75 | ageGroupObservationValue, AgeGroupObservationValue, v3-AgeGroupObservationValue | 0 | 0 | |
| 2.16.840.1.113883.11.76 | knowledgeSubjectObservationValue, KnowledgeSubjectObservationValue, v3-KnowledgeSubjectObservationValue | 0 | 0 | |
| 2.16.840.1.113883.11.77 | knowledgeSubtopicObservationValue, KnowledgeSubtopicObservationValue, v3-KnowledgeSubtopicObservationValue | 0 | 0 | |
| 2.16.840.1.113883.11.78 | observationInterpretation | 0 | 0 | ObservationInterpretation |
| 2.16.840.1.113883.11.79 | loincObservationActContextAgeDefinitionCode, LOINCObservationActContextAgeDefinitionCode, v3-LOINCObservationActContextAgeDefinitionCode | 0 | 0 | |
| 2.16.840.1.113883.11.80 | observationActContextAgeGroupType, ObservationActContextAgeGroupType, v3-ObservationActContextAgeGroupType | 0 | 0 | |
| 2.16.840.1.113883.11.81 | immunizationForecastStatusObservationValue, ImmunizationForecastStatusObservationValue, v3-immunizationForecastStatusObservationValue | 0 | 0 | |
| 2.16.840.1.113883.11.82 | ImmunizationForecastDate, v3-immunizationForecastDate | 0 | 0 | |
| 2.16.840.1.113883.11.83 | ObservationMeasureCountableItems, v3-ObservationMeasureCountableItems | 0 | 0 | |
| 2.16.840.1.113883.11.91 | queryPriority, QueryPriority | 0 | 0 | |
| 2.16.840.1.113883.11.103 | processingID, ProcessingID | 0 | 0 | |
| 2.16.840.1.113883.11.126 | queryQuantityUnit, QueryQuantityUnit | 0 | 0 | |
| 2.16.840.1.113883.11.155 | acknowledgementCondition, AcknowledgementCondition | 0 | 0 | AcknowledgmentCondition |
| 2.16.840.1.113883.11.171 | country, Country | 0 | 0 | |
| 2.16.840.1.113883.11.190 | addressUse, AddressUse | 0 | 0 | |
| 2.16.840.1.113883.11.200 | personNameUse, PersonNameUse | 0 | 0 | |
| 2.16.840.1.113883.11.201 | telecommunicationAddressUse, TelecommunicationAddressUse | 0 | 0 | |
| 2.16.840.1.113883.11.204 | organizationNameType, OrganizationNameType | 0 | 0 | |
| 2.16.840.1.113883.11.207 | processingMode, ProcessingMode | 0 | 0 | |
| 2.16.840.1.113883.11.208 | queryResponse, QueryResponse | 0 | 0 | |
| 2.16.840.1.113883.11.209 | relationalOperator, RelationalOperator | 0 | 0 | |
| 2.16.840.1.113883.11.220 | livingArrangement, LivingArrangement | 0 | 0 | |
| 2.16.840.1.113883.11.227 | vaccineManufacturer, VaccineManufacturer | 0 | 0 | |
| 2.16.840.1.113883.11.228 | vaccineType, VaccineType | 0 | 0 | |
| 2.16.840.1.113883.11.271 | documentCompletion, DocumentCompletion | 0 | 0 | |
| 2.16.840.1.113883.11.275 | documentStorage, DocumentStorage | 0 | 0 | |
| 2.16.840.1.113883.11.295 | personDisabilityType, PersonDisabilityType | 0 | 0 | |
| 2.16.840.1.113883.11.357 | messageCondition, MessageCondition | 0 | 0 | |
| 2.16.840.1.113883.11.390 | sequencing, Sequencing | 0 | 0 | |
| 2.16.840.1.113883.11.394 | responseModality, ResponseModality | 0 | 0 | |
| 2.16.840.1.113883.11.395 | modifyIndicator, ModifyIndicator | 0 | 0 | |
| 2.16.840.1.113883.11.396 | codeSystem, CodeSystem | 0 | 0 | |
| 2.16.840.1.113883.11.10010 | hL7ConformanceInclusion, HL7ConformanceInclusion | 0 | 0 | |
| 2.16.840.1.113883.11.10012 | inclusionNotMandatory, InclusionNotMandatory | 0 | 0 | |
| 2.16.840.1.113883.11.10015 | inclusionNotRequired, InclusionNotRequired | 0 | 0 | |
| 2.16.840.1.113883.11.10018 | hL7UpdateMode, HL7UpdateMode | 0 | 0 | |
| 2.16.840.1.113883.11.10024 | setUpdateMode, SetUpdateMode | 0 | 0 | |
| 2.16.840.1.113883.11.10029 | mDFSubjectAreaPrefix, MDFSubjectAreaPrefix | 0 | 0 | |
| 2.16.840.1.113883.11.10034 | hL7CommitteeIDInRIM, HL7CommitteeIDInRIM | 0 | 0 | |
| 2.16.840.1.113883.11.10045 | mDFAttributeType, MDFAttributeType | 0 | 0 | |
| 2.16.840.1.113883.11.10063 | mdfRmimRowType, MdfRmimRowType | 0 | 0 | |
| 2.16.840.1.113883.11.10069 | mdfHmdRowType, MdfHmdRowType | 0 | 0 | |
| 2.16.840.1.113883.11.10076 | mdfHmdMetSourceType, MdfHmdMetSourceType | 0 | 0 | |
| 2.16.840.1.113883.11.10083 | hL7DefinedRoseProperty, HL7DefinedRoseProperty | 0 | 0 | |
| 2.16.840.1.113883.11.10186 | mobilityImpaired, MobilityImpaired | 0 | 0 |