{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 |
|---|---|---|---|---|
| 2.16.840.1.113883.11.16144 | packageEntityType, PackageEntityType | 0 | 0 | |
| 2.16.840.1.113883.11.16145 | kitEntityType, KitEntityType | 0 | 0 | |
| 2.16.840.1.113883.11.16147 | nonRigidContainerEntityType, NonRigidContainerEntityType | 0 | 0 | |
| 2.16.840.1.113883.11.16152 | rigidContainerEntityType, RigidContainerEntityType | 0 | 0 | |
| 2.16.840.1.113883.11.16153 | multiUseContainerEntityType, MultiUseContainerEntityType | 0 | 0 | |
| 2.16.840.1.113883.11.16155 | bottleEntityType, BottleEntityType | 0 | 0 | |
| 2.16.840.1.113883.11.16159 | plasticBottleEntityType, PlasticBottleEntityType | 0 | 0 | |
| 2.16.840.1.113883.11.16170 | compliancePackageEntityType, CompliancePackageEntityType | 0 | 0 | |
| 2.16.840.1.113883.11.16171 | blisterPackEntityType, BlisterPackEntityType | 0 | 0 | |
| 2.16.840.1.113883.11.16176 | individualPackageEntityType, IndividualPackageEntityType | 0 | 0 | |
| 2.16.840.1.113883.11.16184 | medicationCap, MedicationCap | 0 | 0 | |
| 2.16.840.1.113883.11.16188 | medicalDevice, MedicalDevice | 0 | 0 | |
| 2.16.840.1.113883.11.16189 | administrationMedicalDevice, AdministrationMedicalDevice | 0 | 0 | |
| 2.16.840.1.113883.11.16191 | injectionMedicalDevice, InjectionMedicalDevice | 0 | 0 | |
| 2.16.840.1.113883.11.16196 | inhalerMedicalDevice, InhalerMedicalDevice | 0 | 0 | |
| 2.16.840.1.113883.11.16200 | accessMedicalDevice, AccessMedicalDevice | 0 | 0 | |
| 2.16.840.1.113883.11.16201 | lineAccessMedicalDevice, LineAccessMedicalDevice | 0 | 0 | |
| 2.16.840.1.113883.11.16205 | clinicalDrug, ClinicalDrug | 0 | 0 | |
| 2.16.840.1.113883.11.16206 | manufacturedDrug, ManufacturedDrug | 0 | 0 | |
| 2.16.840.1.113883.11.16208 | actPharmacySupplyType, ActPharmacySupplyType | 0 | 0 | |
| 2.16.840.1.113883.11.16209 | firstFillPharmacySupplyType, FirstFillPharmacySupplyType | 0 | 0 | |
| 2.16.840.1.113883.11.16215 | refillPharmacySupplyType, RefillPharmacySupplyType | 0 | 0 | |
| 2.16.840.1.113883.11.16220 | emergencyPharmacySupplyType, EmergencyPharmacySupplyType | 0 | 0 | |
| 2.16.840.1.113883.11.16226 | observationType, ObservationType | 0 | 0 | |
| 2.16.840.1.113883.11.16228 | observationDiagnosisTypes, ObservationDiagnosisTypes | 0 | 0 | |
| 2.16.840.1.113883.11.16231 | actMonitoringProtocolCode, ActMonitoringProtocolCode | 0 | 0 | |
| 2.16.840.1.113883.11.16232 | controlledSubstanceMonitoringProtocol, ControlledSubstanceMonitoringProtocol | 0 | 0 | |
| 2.16.840.1.113883.11.16346 | parent, Parent | 0 | 0 | |
| 2.16.840.1.113883.11.16349 | grandparent, Grandparent | 0 | 0 | |
| 2.16.840.1.113883.11.16360 | child, Child | 0 | 0 | |
| 2.16.840.1.113883.11.16368 | livingSubjectProductionClass, LivingSubjectProductionClass | 0 | 0 | |
| 2.16.840.1.113883.11.16460 | dentalServiceProviderHIPAA, DentalServiceProviderHIPAA | 0 | 0 | |
| 2.16.840.1.113883.11.16466 | raceAlaskanNativeAleutBristolBay, RaceAlaskanNativeAleutBristolBay | 0 | 0 | |
| 2.16.840.1.113883.11.16478 | contextControl, ContextControl | 0 | 0 | |
| 2.16.840.1.113883.11.16492 | logicalObservationIdentifierNamesAndCodes, LogicalObservationIdentifierNamesAndCodes | 0 | 0 | |
| 2.16.840.1.113883.11.16493 | externallyDefinedActCodes, ExternallyDefinedActCodes | 0 | 0 | |
| 2.16.840.1.113883.11.16501 | clinicalOrganizationRoleType, ClinicalOrganizationRoleType | 0 | 0 | |
| 2.16.840.1.113883.11.16508 | actIncidentCode, ActIncidentCode | 0 | 0 | |
| 2.16.840.1.113883.11.16515 | specimenRoleType, SpecimenRoleType | 0 | 0 | |
| 2.16.840.1.113883.11.16521 | qualitySpecimenRoleType, QualitySpecimenRoleType | 0 | 0 | |
| 2.16.840.1.113883.11.16530 | drugEntity, DrugEntity | 0 | 0 | |
| 2.16.840.1.113883.11.16535 | actProcedureCode, ActProcedureCode | 0 | 0 | |
| 2.16.840.1.113883.11.16537 | actSite, ActSite | 0 | 0 | |
| 2.16.840.1.113883.11.16538 | humanActSite, HumanActSite | 0 | 0 | |
| 2.16.840.1.113883.11.16539 | animalActSite, AnimalActSite | 0 | 0 | |
| 2.16.840.1.113883.11.16541 | procedureMethod, ProcedureMethod | 0 | 0 | |
| 2.16.840.1.113883.11.16543 | participationMode, ParticipationMode | 0 | 0 | |
| 2.16.840.1.113883.11.16544 | participationModeVerbal, ParticipationModeVerbal | 0 | 0 | |
| 2.16.840.1.113883.11.16549 | participationModeWritten, ParticipationModeWritten | 0 | 0 | |
| 2.16.840.1.113883.11.16554 | participationModeElectronicData, ParticipationModeElectronicData | 0 | 0 |