Healthcare Financial Services IG Edition 1
0.3.0 - ci-build
Healthcare Financial Services IG Edition 1 - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
: Adjudication Error - JSON Representation
| Active as of 2025-06-23 |
{
"resourceType" : "CodeSystem",
"id" : "adjudication-error",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-11-11T17:23:48.374+03:00"
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem adjudication-error</b></p><a name=\"adjudication-error\"> </a><a name=\"hcadjudication-error\"> </a><a name=\"adjudication-error-en-US\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: 1; Last updated: 2020-11-11 17:23:48+0300</p></div><p>This case-sensitive code system <code>http://nphies.sa/terminology/CodeSystem/adjudication-error</code> provides <b>a fragment</b> that includes 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\">1191<a name=\"adjudication-error-1191\"> </a></td><td>Missing element: [Patient] within the message</td></tr><tr><td style=\"white-space:nowrap\">1190<a name=\"adjudication-error-1190\"> </a></td><td>Missing element: [Communication.note.text] within the message</td></tr><tr><td style=\"white-space:nowrap\">1199<a name=\"adjudication-error-1199\"> </a></td><td>Missing element: [patient.birthDate] within the message</td></tr><tr><td style=\"white-space:nowrap\">1198<a name=\"adjudication-error-1198\"> </a></td><td>Missing element: [gender.extensionKsaGender] within the message</td></tr><tr><td style=\"white-space:nowrap\">1197<a name=\"adjudication-error-1197\"> </a></td><td>Missing element: [patient.gender ] within the message</td></tr><tr><td style=\"white-space:nowrap\">1196<a name=\"adjudication-error-1196\"> </a></td><td>Missing element: [patient.name] within the message</td></tr><tr><td style=\"white-space:nowrap\">1195<a name=\"adjudication-error-1195\"> </a></td><td>Missing element: [patient.active] within the message</td></tr><tr><td style=\"white-space:nowrap\">1194<a name=\"adjudication-error-1194\"> </a></td><td>Missing element: [patient.identifier] within the message</td></tr><tr><td style=\"white-space:nowrap\">1193<a name=\"adjudication-error-1193\"> </a></td><td>Missing element: [patient.id] within the message</td></tr><tr><td style=\"white-space:nowrap\">260<a name=\"adjudication-error-260\"> </a></td><td>Missing element: [Claim.careTeam.role] within the message</td></tr><tr><td style=\"white-space:nowrap\">1192<a name=\"adjudication-error-1192\"> </a></td><td>Missing element: [patient.resourceType] within the message</td></tr><tr><td style=\"white-space:nowrap\">760<a name=\"adjudication-error-760\"> </a></td><td>Missing element: [Claim.insurance.coverage] within the message</td></tr><tr><td style=\"white-space:nowrap\">761<a name=\"adjudication-error-761\"> </a></td><td>Missing element: [Claim.insurance.preAuthRef] within the message</td></tr><tr><td style=\"white-space:nowrap\">762<a name=\"adjudication-error-762\"> </a></td><td>Missing element: [Claim.insurance.claimResponse] within the message</td></tr><tr><td style=\"white-space:nowrap\">261<a name=\"adjudication-error-261\"> </a></td><td>Missing element: [Claim.supportingInfo] within the message</td></tr><tr><td style=\"white-space:nowrap\">763<a name=\"adjudication-error-763\"> </a></td><td>Missing element: [Claim.accident] within the message</td></tr><tr><td style=\"white-space:nowrap\">764<a name=\"adjudication-error-764\"> </a></td><td>Missing element: [Claim.accident.Date] within the message</td></tr><tr><td style=\"white-space:nowrap\">262<a name=\"adjudication-error-262\"> </a></td><td>Missing element: [Claim.supportingInfo.sequence] within the message</td></tr><tr><td style=\"white-space:nowrap\">765<a name=\"adjudication-error-765\"> </a></td><td>Missing element: [Claim.accident.type] within the message</td></tr><tr><td style=\"white-space:nowrap\">1133<a name=\"adjudication-error-1133\"> </a></td><td>Missing element: [ClaimResponse.processNote] within the message</td></tr><tr><td style=\"white-space:nowrap\">263<a name=\"adjudication-error-263\"> </a></td><td>Missing element: [Claim.supportingInfo.category] within the message</td></tr><tr><td style=\"white-space:nowrap\">766<a name=\"adjudication-error-766\"> </a></td><td>Missing element: [Claim.accident.locationAdress] within the message</td></tr><tr><td style=\"white-space:nowrap\">264<a name=\"adjudication-error-264\"> </a></td><td>Missing element: [Claim.supportingInfo.code] within the message</td></tr><tr><td style=\"white-space:nowrap\">1625<a name=\"adjudication-error-1625\"> </a></td><td>ClaimResponse.item.detail.Sequence detailSequence in the claim response SHALL match item.detail.sequence within the claim.item</td></tr><tr><td style=\"white-space:nowrap\">1132<a name=\"adjudication-error-1132\"> </a></td><td>Missing element: [ClaimResponse.fundsReserve] within the message</td></tr><tr><td style=\"white-space:nowrap\">767<a name=\"adjudication-error-767\"> </a></td><td>Missing element: [Claim.item] within the message</td></tr><tr><td style=\"white-space:nowrap\">34<a name=\"adjudication-error-34\"> </a></td><td>Missing element: [CoverageEligibilityResponse.patient] within the message</td></tr><tr><td style=\"white-space:nowrap\">265<a name=\"adjudication-error-265\"> </a></td><td>Missing element: [Claim.supportingInfo.timingDate] within the message</td></tr><tr><td style=\"white-space:nowrap\">1189<a name=\"adjudication-error-1189\"> </a></td><td>Missing element: [Communication.note.time] within the message</td></tr><tr><td style=\"white-space:nowrap\">1131<a name=\"adjudication-error-1131\"> </a></td><td>Missing element: [ClaimResponse.total.amount.currency] within the message</td></tr><tr><td style=\"white-space:nowrap\">768<a name=\"adjudication-error-768\"> </a></td><td>Missing element: [Claim.item.extension.tax] within the message</td></tr><tr><td style=\"white-space:nowrap\">1130<a name=\"adjudication-error-1130\"> </a></td><td>Missing element: [ClaimResponse.total.amount.value] within the message</td></tr><tr><td style=\"white-space:nowrap\">266<a name=\"adjudication-error-266\"> </a></td><td>Missing element: [Claim.supportingInfo.timingPeriod] within the message</td></tr><tr><td style=\"white-space:nowrap\">1624<a name=\"adjudication-error-1624\"> </a></td><td>ClaimResponse.item.detail.Sequence detailSequence in the claim response SHALL match item.detail.sequence within the claim.item</td></tr><tr><td style=\"white-space:nowrap\">769<a name=\"adjudication-error-769\"> </a></td><td>Missing element: [Claim.item.sequence] within the message</td></tr><tr><td style=\"white-space:nowrap\">35<a name=\"adjudication-error-35\"> </a></td><td>Missing element: [CoverageEligibilityResponse.servicedDate] within the message</td></tr><tr><td style=\"white-space:nowrap\">770<a name=\"adjudication-error-770\"> </a></td><td>Missing element: [Claim.item.careTeamSequence] within the message</td></tr><tr><td style=\"white-space:nowrap\">267<a name=\"adjudication-error-267\"> </a></td><td>Missing element: [Claim.supportingInfo.valueBoolean] within the message</td></tr><tr><td style=\"white-space:nowrap\">1672<a name=\"adjudication-error-1672\"> </a></td><td>Services performed outside the coverage effective period</td></tr><tr><td style=\"white-space:nowrap\">36<a name=\"adjudication-error-36\"> </a></td><td>Missing element: [CoverageEligibilityResponse.created] within the message</td></tr><tr><td style=\"white-space:nowrap\">268<a name=\"adjudication-error-268\"> </a></td><td>Missing element: [Claim.supportingInfo.valueString] within the message</td></tr><tr><td style=\"white-space:nowrap\">1177<a name=\"adjudication-error-1177\"> </a></td><td>Missing element: [Communication.subject] within the message</td></tr><tr><td style=\"white-space:nowrap\">37<a name=\"adjudication-error-37\"> </a></td><td>Missing element: [CoverageEligibilityResponse.request] within the message</td></tr><tr><td style=\"white-space:nowrap\">269<a name=\"adjudication-error-269\"> </a></td><td>Missing element: [Claim.supportingInfo.valueQuantity] within the message</td></tr><tr><td style=\"white-space:nowrap\">1176<a name=\"adjudication-error-1176\"> </a></td><td>Missing element: [Communication.medium] within the message</td></tr><tr><td style=\"white-space:nowrap\">12<a name=\"adjudication-error-12\"> </a></td><td>Missing element: [entry.CoverageEligibilityRequest] within the message</td></tr><tr><td style=\"white-space:nowrap\">1671<a name=\"adjudication-error-1671\"> </a></td><td>The requested medicine(s) is not registered</td></tr><tr><td style=\"white-space:nowrap\">38<a name=\"adjudication-error-38\"> </a></td><td>Missing element: [CoverageEligibilityResponse.outcome] within the message</td></tr><tr><td style=\"white-space:nowrap\">1175<a name=\"adjudication-error-1175\"> </a></td><td>Missing element: [Communication.priority] within the message</td></tr><tr><td style=\"white-space:nowrap\">270<a name=\"adjudication-error-270\"> </a></td><td>Missing element: [Claim.supportingInfo.valueAttachment] within the message</td></tr><tr><td style=\"white-space:nowrap\">340<a name=\"adjudication-error-340\"> </a></td><td>Missing element: [Claim.fundsReserve] within the message</td></tr><tr><td style=\"white-space:nowrap\">39<a name=\"adjudication-error-39\"> </a></td><td>Missing element: [CoverageEligibilityResponse.disposition] within the message</td></tr><tr><td style=\"white-space:nowrap\">1174<a name=\"adjudication-error-1174\"> </a></td><td>Missing element: [Communication.category] within the message</td></tr><tr><td style=\"white-space:nowrap\">1670<a name=\"adjudication-error-1670\"> </a></td><td>Service code is inconsistent with the patient's gender</td></tr><tr><td style=\"white-space:nowrap\">13<a name=\"adjudication-error-13\"> </a></td><td>Missing element: [CoverageEligibilityRequest.resourceType] within the message</td></tr><tr><td style=\"white-space:nowrap\">380<a name=\"adjudication-error-380\"> </a></td><td>Missing element: [Claim.item.extension.tax] within the message</td></tr><tr><td style=\"white-space:nowrap\">271<a name=\"adjudication-error-271\"> </a></td><td>Missing element: [Claim.supportingInfo.valueReference] within the message</td></tr><tr><td style=\"white-space:nowrap\">1669<a name=\"adjudication-error-1669\"> </a></td><td>Diagnosis is inconsistent with the patient's gender</td></tr><tr><td style=\"white-space:nowrap\">14<a name=\"adjudication-error-14\"> </a></td><td>Missing element: [CoverageEligibilityRequest.id] within the message</td></tr><tr><td style=\"white-space:nowrap\">381<a name=\"adjudication-error-381\"> </a></td><td>Missing element: [Claim.item.sequence] within the message</td></tr><tr><td style=\"white-space:nowrap\">1668<a name=\"adjudication-error-1668\"> </a></td><td>Supporting information not related to the patient</td></tr><tr><td style=\"white-space:nowrap\">272<a name=\"adjudication-error-272\"> </a></td><td>Missing element: [Claim.supportingInfo.reason] within the message</td></tr><tr><td style=\"white-space:nowrap\">382<a name=\"adjudication-error-382\"> </a></td><td>Missing element: [Claim.item.careTeamSequence] within the message</td></tr><tr><td style=\"white-space:nowrap\">1667<a name=\"adjudication-error-1667\"> </a></td><td>The service code is invalid given the patient history</td></tr><tr><td style=\"white-space:nowrap\">1666<a name=\"adjudication-error-1666\"> </a></td><td>Provider not licensed during the date of service</td></tr><tr><td style=\"white-space:nowrap\">273<a name=\"adjudication-error-273\"> </a></td><td>Missing element: [Claim.diagnosis] within the message</td></tr><tr><td style=\"white-space:nowrap\">1665<a name=\"adjudication-error-1665\"> </a></td><td>New born exceeds 30 days of age</td></tr><tr><td style=\"white-space:nowrap\">274<a name=\"adjudication-error-274\"> </a></td><td>Missing element: [Claim.diagnosis.sequence] within the message</td></tr><tr><td style=\"white-space:nowrap\">1129<a name=\"adjudication-error-1129\"> </a></td><td>Missing element: [ClaimResponse.total.amount] within the message</td></tr><tr><td style=\"white-space:nowrap\">1664<a name=\"adjudication-error-1664\"> </a></td><td>Policy is cancelled/expired</td></tr><tr><td style=\"white-space:nowrap\">275<a name=\"adjudication-error-275\"> </a></td><td>Missing element: [Claim.diagnosis.diagnosisCodeableConcept] within the message</td></tr><tr><td style=\"white-space:nowrap\">1663<a name=\"adjudication-error-1663\"> </a></td><td>MEMBER DELETED</td></tr><tr><td style=\"white-space:nowrap\">1662<a name=\"adjudication-error-1662\"> </a></td><td>Tooth number is missing</td></tr><tr><td style=\"white-space:nowrap\">276<a name=\"adjudication-error-276\"> </a></td><td>Missing element: [Claim.diagnosis.type] within the message</td></tr><tr><td style=\"white-space:nowrap\">1682<a name=\"adjudication-error-1682\"> </a></td><td>The patient information does not match the insurance member details.</td></tr><tr><td style=\"white-space:nowrap\">1128<a name=\"adjudication-error-1128\"> </a></td><td>Missing element: [ClaimResponse.total.category] within the message</td></tr><tr><td style=\"white-space:nowrap\">320<a name=\"adjudication-error-320\"> </a></td><td>Missing element: [Claim.item.detail.subDetail.unitPrice] within the message</td></tr><tr><td style=\"white-space:nowrap\">277<a name=\"adjudication-error-277\"> </a></td><td>Missing element: [Claim.insurance] within the message</td></tr><tr><td style=\"white-space:nowrap\">1111<a name=\"adjudication-error-1111\"> </a></td><td>Missing element: [ClaimResponse.item.detail.noteNumber] within the message</td></tr><tr><td style=\"white-space:nowrap\">1127<a name=\"adjudication-error-1127\"> </a></td><td>Missing element: [ClaimResponse.total] within the message</td></tr><tr><td style=\"white-space:nowrap\">278<a name=\"adjudication-error-278\"> </a></td><td>Missing element: [Claim.insurance.sequence] within the message</td></tr><tr><td style=\"white-space:nowrap\">1126<a name=\"adjudication-error-1126\"> </a></td><td>Missing element: [ClaimResponse.item.detail.subDetail.adjudication.amount.currency] within the message</td></tr><tr><td style=\"white-space:nowrap\">279<a name=\"adjudication-error-279\"> </a></td><td>Missing element: [Claim.insurance.focal] within the message</td></tr><tr><td style=\"white-space:nowrap\">1125<a name=\"adjudication-error-1125\"> </a></td><td>Missing element: [ClaimResponse.item.detail.subDetail.adjudication.amount.value] within the message</td></tr><tr><td style=\"white-space:nowrap\">1595<a name=\"adjudication-error-1595\"> </a></td><td>Claim serviced SHALL be on OR after the creation date if the claim use=Authorization</td></tr><tr><td style=\"white-space:nowrap\">56<a name=\"adjudication-error-56\"> </a></td><td>Missing element: [Claim.status] within the message</td></tr><tr><td style=\"white-space:nowrap\">700<a name=\"adjudication-error-700\"> </a></td><td>Missing element: [Claim.item.detail.subDetail.sequence] within the message</td></tr><tr><td style=\"white-space:nowrap\">57<a name=\"adjudication-error-57\"> </a></td><td>Missing element: [Claim.type] within the message</td></tr><tr><td style=\"white-space:nowrap\">1124<a name=\"adjudication-error-1124\"> </a></td><td>Missing element: [ClaimResponse.item.detail.subDetail.adjudication.amount] within the message</td></tr><tr><td style=\"white-space:nowrap\">321<a name=\"adjudication-error-321\"> </a></td><td>Missing element: [Claim.item.detail.subDetail.net] within the message</td></tr><tr><td style=\"white-space:nowrap\">1110<a name=\"adjudication-error-1110\"> </a></td><td>Missing element: [ClaimResponse.item.detail.detailSequence] within the message</td></tr><tr><td style=\"white-space:nowrap\">58<a name=\"adjudication-error-58\"> </a></td><td>Missing element: [Claim.subType] within the message</td></tr><tr><td style=\"white-space:nowrap\">701<a name=\"adjudication-error-701\"> </a></td><td>Missing element: [Claim.item.detail.subDetail.productOrService] within the message</td></tr><tr><td style=\"white-space:nowrap\">771<a name=\"adjudication-error-771\"> </a></td><td>Missing element: [Claim.item.diagnosisSequence] within the message</td></tr><tr><td style=\"white-space:nowrap\">59<a name=\"adjudication-error-59\"> </a></td><td>Missing element: [Claim.use] within the message</td></tr><tr><td style=\"white-space:nowrap\">1123<a name=\"adjudication-error-1123\"> </a></td><td>Missing element: [ClaimResponse.item.detail.subDetail.adjudication.reason] within the message</td></tr><tr><td style=\"white-space:nowrap\">1594<a name=\"adjudication-error-1594\"> </a></td><td>Claim.billablePeriod SHALL be within the encounter start and end date if encounter is provided</td></tr><tr><td style=\"white-space:nowrap\">322<a name=\"adjudication-error-322\"> </a></td><td>Missing element: [Claim.item.detail.subDetail.udi] within the message</td></tr><tr><td style=\"white-space:nowrap\">60<a name=\"adjudication-error-60\"> </a></td><td>Missing element: [Claim.patient] within the message</td></tr><tr><td style=\"white-space:nowrap\">1593<a name=\"adjudication-error-1593\"> </a></td><td>Claim.subType If Claim type is profesional ,then the Claim sub-type SHALL not be IP</td></tr></table></div>"
},
"url" : "http://nphies.sa/terminology/CodeSystem/adjudication-error",
"version" : "0.3.0",
"name" : "AdjudicationError",
"title" : "Adjudication Error",
"status" : "active",
"experimental" : false,
"date" : "2025-06-23T22:09:21+03:00",
"publisher" : "HL7 Saudi Arabia",
"contact" : [
{
"name" : "HL7 Saudi Arabia",
"telecom" : [
{
"system" : "url",
"value" : "http://test-project.org/test-publisher"
}
]
}
],
"description" : "This code set includes a set of adjudication error codes which may be issued during the validation of a message.",
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "SA",
"display" : "Saudi Arabia"
}
]
}
],
"copyright" : "nphies 2020+ (https://nphies.sa)",
"caseSensitive" : true,
"compositional" : false,
"versionNeeded" : false,
"content" : "fragment",
"concept" : [
{
"code" : "1191",
"display" : "Missing element: [Patient] within the message"
},
{
"code" : "1190",
"display" : "Missing element: [Communication.note.text] within the message"
},
{
"code" : "1199",
"display" : "Missing element: [patient.birthDate] within the message"
},
{
"code" : "1198",
"display" : "Missing element: [gender.extensionKsaGender] within the message"
},
{
"code" : "1197",
"display" : "Missing element: [patient.gender ] within the message"
},
{
"code" : "1196",
"display" : "Missing element: [patient.name] within the message"
},
{
"code" : "1195",
"display" : "Missing element: [patient.active] within the message"
},
{
"code" : "1194",
"display" : "Missing element: [patient.identifier] within the message"
},
{
"code" : "1193",
"display" : "Missing element: [patient.id] within the message"
},
{
"code" : "260",
"display" : "Missing element: [Claim.careTeam.role] within the message"
},
{
"code" : "1192",
"display" : "Missing element: [patient.resourceType] within the message"
},
{
"code" : "760",
"display" : "Missing element: [Claim.insurance.coverage] within the message"
},
{
"code" : "761",
"display" : "Missing element: [Claim.insurance.preAuthRef] within the message"
},
{
"code" : "762",
"display" : "Missing element: [Claim.insurance.claimResponse] within the message"
},
{
"code" : "261",
"display" : "Missing element: [Claim.supportingInfo] within the message"
},
{
"code" : "763",
"display" : "Missing element: [Claim.accident] within the message"
},
{
"code" : "764",
"display" : "Missing element: [Claim.accident.Date] within the message"
},
{
"code" : "262",
"display" : "Missing element: [Claim.supportingInfo.sequence] within the message"
},
{
"code" : "765",
"display" : "Missing element: [Claim.accident.type] within the message"
},
{
"code" : "1133",
"display" : "Missing element: [ClaimResponse.processNote] within the message"
},
{
"code" : "263",
"display" : "Missing element: [Claim.supportingInfo.category] within the message"
},
{
"code" : "766",
"display" : "Missing element: [Claim.accident.locationAdress] within the message"
},
{
"code" : "264",
"display" : "Missing element: [Claim.supportingInfo.code] within the message"
},
{
"code" : "1625",
"display" : "ClaimResponse.item.detail.Sequence detailSequence in the claim response SHALL match item.detail.sequence within the claim.item"
},
{
"code" : "1132",
"display" : "Missing element: [ClaimResponse.fundsReserve] within the message"
},
{
"code" : "767",
"display" : "Missing element: [Claim.item] within the message"
},
{
"code" : "34",
"display" : "Missing element: [CoverageEligibilityResponse.patient] within the message"
},
{
"code" : "265",
"display" : "Missing element: [Claim.supportingInfo.timingDate] within the message"
},
{
"code" : "1189",
"display" : "Missing element: [Communication.note.time] within the message"
},
{
"code" : "1131",
"display" : "Missing element: [ClaimResponse.total.amount.currency] within the message"
},
{
"code" : "768",
"display" : "Missing element: [Claim.item.extension.tax] within the message"
},
{
"code" : "1130",
"display" : "Missing element: [ClaimResponse.total.amount.value] within the message"
},
{
"code" : "266",
"display" : "Missing element: [Claim.supportingInfo.timingPeriod] within the message"
},
{
"code" : "1624",
"display" : "ClaimResponse.item.detail.Sequence detailSequence in the claim response SHALL match item.detail.sequence within the claim.item"
},
{
"code" : "769",
"display" : "Missing element: [Claim.item.sequence] within the message"
},
{
"code" : "35",
"display" : "Missing element: [CoverageEligibilityResponse.servicedDate] within the message"
},
{
"code" : "770",
"display" : "Missing element: [Claim.item.careTeamSequence] within the message"
},
{
"code" : "267",
"display" : "Missing element: [Claim.supportingInfo.valueBoolean] within the message"
},
{
"code" : "1672",
"display" : "Services performed outside the coverage effective period"
},
{
"code" : "36",
"display" : "Missing element: [CoverageEligibilityResponse.created] within the message"
},
{
"code" : "268",
"display" : "Missing element: [Claim.supportingInfo.valueString] within the message"
},
{
"code" : "1177",
"display" : "Missing element: [Communication.subject] within the message"
},
{
"code" : "37",
"display" : "Missing element: [CoverageEligibilityResponse.request] within the message"
},
{
"code" : "269",
"display" : "Missing element: [Claim.supportingInfo.valueQuantity] within the message"
},
{
"code" : "1176",
"display" : "Missing element: [Communication.medium] within the message"
},
{
"code" : "12",
"display" : "Missing element: [entry.CoverageEligibilityRequest] within the message"
},
{
"code" : "1671",
"display" : "The requested medicine(s) is not registered"
},
{
"code" : "38",
"display" : "Missing element: [CoverageEligibilityResponse.outcome] within the message"
},
{
"code" : "1175",
"display" : "Missing element: [Communication.priority] within the message"
},
{
"code" : "270",
"display" : "Missing element: [Claim.supportingInfo.valueAttachment] within the message"
},
{
"code" : "340",
"display" : "Missing element: [Claim.fundsReserve] within the message"
},
{
"code" : "39",
"display" : "Missing element: [CoverageEligibilityResponse.disposition] within the message"
},
{
"code" : "1174",
"display" : "Missing element: [Communication.category] within the message"
},
{
"code" : "1670",
"display" : "Service code is inconsistent with the patient's gender"
},
{
"code" : "13",
"display" : "Missing element: [CoverageEligibilityRequest.resourceType] within the message"
},
{
"code" : "380",
"display" : "Missing element: [Claim.item.extension.tax] within the message"
},
{
"code" : "271",
"display" : "Missing element: [Claim.supportingInfo.valueReference] within the message"
},
{
"code" : "1669",
"display" : "Diagnosis is inconsistent with the patient's gender"
},
{
"code" : "14",
"display" : "Missing element: [CoverageEligibilityRequest.id] within the message"
},
{
"code" : "381",
"display" : "Missing element: [Claim.item.sequence] within the message"
},
{
"code" : "1668",
"display" : "Supporting information not related to the patient"
},
{
"code" : "272",
"display" : "Missing element: [Claim.supportingInfo.reason] within the message"
},
{
"code" : "382",
"display" : "Missing element: [Claim.item.careTeamSequence] within the message"
},
{
"code" : "1667",
"display" : "The service code is invalid given the patient history"
},
{
"code" : "1666",
"display" : "Provider not licensed during the date of service"
},
{
"code" : "273",
"display" : "Missing element: [Claim.diagnosis] within the message"
},
{
"code" : "1665",
"display" : "New born exceeds 30 days of age"
},
{
"code" : "274",
"display" : "Missing element: [Claim.diagnosis.sequence] within the message"
},
{
"code" : "1129",
"display" : "Missing element: [ClaimResponse.total.amount] within the message"
},
{
"code" : "1664",
"display" : "Policy is cancelled/expired"
},
{
"code" : "275",
"display" : "Missing element: [Claim.diagnosis.diagnosisCodeableConcept] within the message"
},
{
"code" : "1663",
"display" : "MEMBER DELETED"
},
{
"code" : "1662",
"display" : "Tooth number is missing"
},
{
"code" : "276",
"display" : "Missing element: [Claim.diagnosis.type] within the message"
},
{
"code" : "1682",
"display" : "The patient information does not match the insurance member details."
},
{
"code" : "1128",
"display" : "Missing element: [ClaimResponse.total.category] within the message"
},
{
"code" : "320",
"display" : "Missing element: [Claim.item.detail.subDetail.unitPrice] within the message"
},
{
"code" : "277",
"display" : "Missing element: [Claim.insurance] within the message"
},
{
"code" : "1111",
"display" : "Missing element: [ClaimResponse.item.detail.noteNumber] within the message"
},
{
"code" : "1127",
"display" : "Missing element: [ClaimResponse.total] within the message"
},
{
"code" : "278",
"display" : "Missing element: [Claim.insurance.sequence] within the message"
},
{
"code" : "1126",
"display" : "Missing element: [ClaimResponse.item.detail.subDetail.adjudication.amount.currency] within the message"
},
{
"code" : "279",
"display" : "Missing element: [Claim.insurance.focal] within the message"
},
{
"code" : "1125",
"display" : "Missing element: [ClaimResponse.item.detail.subDetail.adjudication.amount.value] within the message"
},
{
"code" : "1595",
"display" : "Claim serviced SHALL be on OR after the creation date if the claim use=Authorization"
},
{
"code" : "56",
"display" : "Missing element: [Claim.status] within the message"
},
{
"code" : "700",
"display" : "Missing element: [Claim.item.detail.subDetail.sequence] within the message"
},
{
"code" : "57",
"display" : "Missing element: [Claim.type] within the message"
},
{
"code" : "1124",
"display" : "Missing element: [ClaimResponse.item.detail.subDetail.adjudication.amount] within the message"
},
{
"code" : "321",
"display" : "Missing element: [Claim.item.detail.subDetail.net] within the message"
},
{
"code" : "1110",
"display" : "Missing element: [ClaimResponse.item.detail.detailSequence] within the message"
},
{
"code" : "58",
"display" : "Missing element: [Claim.subType] within the message"
},
{
"code" : "701",
"display" : "Missing element: [Claim.item.detail.subDetail.productOrService] within the message"
},
{
"code" : "771",
"display" : "Missing element: [Claim.item.diagnosisSequence] within the message"
},
{
"code" : "59",
"display" : "Missing element: [Claim.use] within the message"
},
{
"code" : "1123",
"display" : "Missing element: [ClaimResponse.item.detail.subDetail.adjudication.reason] within the message"
},
{
"code" : "1594",
"display" : "Claim.billablePeriod SHALL be within the encounter start and end date if encounter is provided"
},
{
"code" : "322",
"display" : "Missing element: [Claim.item.detail.subDetail.udi] within the message"
},
{
"code" : "60",
"display" : "Missing element: [Claim.patient] within the message"
},
{
"code" : "1593",
"display" : "Claim.subType If Claim type is profesional ,then the Claim sub-type SHALL not be IP"
}
]
}