FHIR Implementation Guide for ABDM
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FHIR Implementation Guide for ABDM - Local Development build (v6.5.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

CodeSystem: Claim Exclusion

Official URL: https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion Version: 6.5.0
Draft as of 2023-07-05 Computable Name: ClaimExclusion

This CodeSystem comprises codes that describes excluded coverage within a health insurance product.

This Code system is referenced in the content logical definition of the following value sets:

Generated Narrative: CodeSystem ndhm-claim-exclusion

This case-sensitive code system https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion defines the following codes:

CodeDisplay
Excl01 Pre-Existing Diseases
Excl02 Specified disease/procedure waiting period
Excl03 30-day waiting period
Excl04 Investigation Evaluation
Excl05 Rest Cure,Rehabilitation and Respite Care
Excl06 Obesity/Weight Control
Excl07 Change-of-Gender treatments
Excl08 Cosmetic or plastic Surgery
Excl09 Hazardous or Adventure sports
Excl10 Breach of law
Excl11 Excluded Providers
Excl12 Rehabilitation
Excl13 Hydrotherapy
Excl14 Non-prescription
Excl15 Refractive Error
Excl16 Unproven Treatments
Excl17 Sterility and Infertility
Excl18 Maternity Expenses
IIB13 Fraudulent Claim
IIB14 Sum insured exhausted
IIB15 Withdrawal by the Insured
IIB16 Suppression of Material Information
IIB17 Waiting Period beyond 30 days
IIB20 Not covered under the Terms and Conditions of the contract