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Type:
Change Request
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Resolution: Unresolved
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Priority:
Medium
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FHIR Core (FHIR)
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STU3
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Financial Mgmt
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ClaimResponse
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Enhancement
The outcome value set on ClaimResponse is a required binding to a value set of four codes. X12 has a set of codes that encompass the four codes but also has some that have more detail or that aren't in the set. Since the binding is required, that means we are stuck.
Example: If the review of the claim requires additional medical information and is thus pending waiting for the information, that could map to the code 'partial' but I'd really rather have a code that gave more information.