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: Adjudication Outcome - JSON Representation

Active as of 2025-07-30

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{
  "resourceType" : "CodeSystem",
  "id" : "adjudication-outcome",
  "meta" : {
    "versionId" : "4",
    "lastUpdated" : "2024-08-15T10:35:13.09+03:00"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem adjudication-outcome</b></p><a name=\"adjudication-outcome\"> </a><a name=\"hcadjudication-outcome\"> </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: 4; Last updated: 2024-08-15 10:35:13+0300</p></div><p>This case-sensitive code system <code>http://nphies.sa/terminology/CodeSystem/adjudication-outcome</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td><td><b>Arabic (ar)</b></td></tr><tr><td style=\"white-space:nowrap\">not-required<a name=\"adjudication-outcome-not-required\"> </a></td><td>Not Required</td><td>No Authorization is required for this request</td><td>لا يتطلب موافقة مسبقة</td></tr><tr><td style=\"white-space:nowrap\">pended<a name=\"adjudication-outcome-pended\"> </a></td><td>Pended</td><td>The processing of the requested has been pended awaiting further information or processing</td><td>معلّق</td></tr><tr><td style=\"white-space:nowrap\">approved<a name=\"adjudication-outcome-approved\"> </a></td><td>Approved</td><td>All items approved</td><td>موافق عليه-مقبول</td></tr><tr><td style=\"white-space:nowrap\">rejected<a name=\"adjudication-outcome-rejected\"> </a></td><td>Rejected</td><td>All items rejected</td><td>مرفوض</td></tr><tr><td style=\"white-space:nowrap\">partial<a name=\"adjudication-outcome-partial\"> </a></td><td>Partially Approved</td><td>At least one item rejected</td><td>مقبول جزئيًا</td></tr></table></div>"
  },
  "url" : "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
  "version" : "0.3.0",
  "name" : "AdjudicationOutcome",
  "title" : "Adjudication Outcome",
  "status" : "active",
  "experimental" : false,
  "date" : "2025-07-30T12:41:32+03:00",
  "publisher" : "HL7 Saudi Arabia",
  "contact" : [
    {
      "name" : "HL7 Saudi Arabia",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://test-project.org/test-publisher"
        }
      ]
    }
  ],
  "description" : "A code indicating the outcome of the adjudication such as rejected, partially approved/paid or approved/paid as submitted.",
  "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" : "complete",
  "concept" : [
    {
      "code" : "not-required",
      "display" : "Not Required",
      "definition" : "No Authorization is required for this request",
      "designation" : [
        {
          "language" : "ar",
          "value" : "لا يتطلب موافقة مسبقة"
        }
      ]
    },
    {
      "code" : "pended",
      "display" : "Pended",
      "definition" : "The processing of the requested has been pended awaiting further information or processing",
      "designation" : [
        {
          "language" : "ar",
          "value" : "معلّق"
        }
      ]
    },
    {
      "code" : "approved",
      "display" : "Approved",
      "definition" : "All items approved",
      "designation" : [
        {
          "language" : "ar",
          "value" : "موافق عليه-مقبول"
        }
      ]
    },
    {
      "code" : "rejected",
      "display" : "Rejected",
      "definition" : "All items rejected",
      "designation" : [
        {
          "language" : "ar",
          "value" : "مرفوض"
        }
      ]
    },
    {
      "code" : "partial",
      "display" : "Partially Approved",
      "definition" : "At least one item rejected",
      "designation" : [
        {
          "language" : "ar",
          "value" : "مقبول جزئيًا"
        }
      ]
    }
  ]
}