: Billing Rule Effect - XML Representation
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<CodeSystem xmlns="http://hl7.org/fhir">
<id value="billing-rule-effect"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CodeSystem billing-rule-effect</b></p><a name="billing-rule-effect"> </a><a name="hcbilling-rule-effect"> </a><p>This case-sensitive code system <code>https://fhir.cognovis.de/praxis/CodeSystem/billing-rule-effect</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></tr><tr><td style="white-space:nowrap">reject<a name="billing-rule-effect-reject"> </a></td><td>Reject</td><td>The billed item is non-conformant and must be rejected or corrected.</td></tr><tr><td style="white-space:nowrap">requires-justification<a name="billing-rule-effect-requires-justification"> </a></td><td>Requires justification</td><td>The billed item requires a documented justification.</td></tr><tr><td style="white-space:nowrap">requires-approval<a name="billing-rule-effect-requires-approval"> </a></td><td>Requires approval</td><td>The billed item requires an applicable approval or authorization.</td></tr><tr><td style="white-space:nowrap">requires-agreement<a name="billing-rule-effect-requires-agreement"> </a></td><td>Requires agreement</td><td>The billed item requires an applicable patient or contractual agreement.</td></tr><tr><td style="white-space:nowrap">replace-code<a name="billing-rule-effect-replace-code"> </a></td><td>Replace code</td><td>The billed item must be replaced by a declared alternative code.</td></tr><tr><td style="white-space:nowrap">price-adjust<a name="billing-rule-effect-price-adjust"> </a></td><td>Price adjustment</td><td>The rule changes the applicable price, points, factor, or valuation.</td></tr><tr><td style="white-space:nowrap">advisory<a name="billing-rule-effect-advisory"> </a></td><td>Advisory</td><td>The rule produces a non-blocking advisory finding.</td></tr><tr><td style="white-space:nowrap">reporting-only<a name="billing-rule-effect-reporting-only"> </a></td><td>Reporting only</td><td>The rule produces a reporting obligation without changing billability.</td></tr></table></div>
</text>
<url
value="https://fhir.cognovis.de/praxis/CodeSystem/billing-rule-effect"/>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:oid:2.16.840.1.113883.3.7985.16.21"/>
</identifier>
<version value="1"/>
<name value="BillingRuleEffectCS"/>
<title value="Billing Rule Effect"/>
<status value="active"/>
<experimental value="false"/>
<date value="2026-08-22T18:18:46+02:00"/>
<publisher value="cognovis GmbH"/>
<contact>
<name value="cognovis GmbH"/>
<telecom>
<system value="url"/>
<value value="https://www.cognovis.de"/>
</telecom>
<telecom>
<system value="email"/>
<value value="info@cognovis.de"/>
</telecom>
</contact>
<description
value="Observable effects produced when a declarative billing rule matches or is violated."/>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="DE"/>
</coding>
</jurisdiction>
<copyright
value="Copyright 2026+ cognovis GmbH. Cognovis-authored material is licensed under Apache-2.0; third-party material retains its own terms as documented in THIRD_PARTY_NOTICES.md."/>
<caseSensitive value="true"/>
<content value="complete"/>
<count value="8"/>
<concept>
<code value="reject"/>
<display value="Reject"/>
<definition
value="The billed item is non-conformant and must be rejected or corrected."/>
</concept>
<concept>
<code value="requires-justification"/>
<display value="Requires justification"/>
<definition value="The billed item requires a documented justification."/>
</concept>
<concept>
<code value="requires-approval"/>
<display value="Requires approval"/>
<definition
value="The billed item requires an applicable approval or authorization."/>
</concept>
<concept>
<code value="requires-agreement"/>
<display value="Requires agreement"/>
<definition
value="The billed item requires an applicable patient or contractual agreement."/>
</concept>
<concept>
<code value="replace-code"/>
<display value="Replace code"/>
<definition
value="The billed item must be replaced by a declared alternative code."/>
</concept>
<concept>
<code value="price-adjust"/>
<display value="Price adjustment"/>
<definition
value="The rule changes the applicable price, points, factor, or valuation."/>
</concept>
<concept>
<code value="advisory"/>
<display value="Advisory"/>
<definition value="The rule produces a non-blocking advisory finding."/>
</concept>
<concept>
<code value="reporting-only"/>
<display value="Reporting only"/>
<definition
value="The rule produces a reporting obligation without changing billability."/>
</concept>
</CodeSystem>
