Generated Narrative: CodeSystem billing-rule-effect This case-sensitive code system https://fhir.cognovis.de/praxis/CodeSystem/billing-rule-effect defines the following codes: Code Display Definition reject Reject The billed item is non-conformant and must be rejected or corrected. requires-justification Requires justification The billed item requires a documented justification. requires-approval Requires approval The billed item requires an applicable approval or authorization. requires-agreement Requires agreement The billed item requires an applicable patient or contractual agreement. replace-code Replace code The billed item must be replaced by a declared alternative code. price-adjust Price adjustment The rule changes the applicable price, points, factor, or valuation. advisory Advisory The rule produces a non-blocking advisory finding. reporting-only Reporting only The rule produces a reporting obligation without changing billability.
Observable effects produced when a declarative billing rule matches or is violated.
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The billed item is non-conformant and must be rejected or corrected.
The billed item requires a documented justification.
The billed item requires an applicable approval or authorization.
The billed item requires an applicable patient or contractual agreement.
The billed item must be replaced by a declared alternative code.
The rule changes the applicable price, points, factor, or valuation.
The rule produces a non-blocking advisory finding.
The rule produces a reporting obligation without changing billability.