FHIR Implementation Guide for ABDM
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FHIR Implementation Guide for ABDM - Local Development build (v7.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

ValueSet: Claim Exclusion

Official URL: https://nrces.in/ndhm/fhir/r4/ValueSet/ndhm-claim-exclusion Version: 7.0.0
Draft as of 2023-07-20 Computable Name: ClaimExclusion

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

References

Logical Definition (CLD)

 

Expansion

Expansion performed internally based on codesystem Claim Exclusion v7.0.0 (CodeSystem)

This value set contains 24 concepts

SystemCodeDisplay (en)DefinitionJSONXML
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl01Pre-Existing Diseases
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl02Specified disease/procedure waiting period
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl0330-day waiting period
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl04Investigation Evaluation
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl05Rest Cure,Rehabilitation and Respite Care
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl06Obesity/Weight Control
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl07Change-of-Gender treatments
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl08Cosmetic or plastic Surgery
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl09Hazardous or Adventure sports
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl10Breach of law
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl11Excluded Providers
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl12Rehabilitation
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl13Hydrotherapy
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl14Non-prescription
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl15Refractive Error
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl16Unproven Treatments
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl17Sterility and Infertility
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  Excl18Maternity Expenses
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  IIB13Fraudulent Claim
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  IIB14Sum insured exhausted
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  IIB15Withdrawal by the Insured
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  IIB16Suppression of Material Information
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  IIB17Waiting Period beyond 30 days
https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion  IIB20Not covered under the Terms and Conditions of the contract

Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code