To trigger internal reviews when a medication claim is accepted but requires an adjustment based on specific plan policies. 5. Related Codes for Comparison Definition Key Difference 21682 Adjudicated with Adjustments Accepted but the value changed. 21681 Adjudicated as Zero Accepted but with a $0 payment. 21683 Adjudicated with No Changes Accepted exactly as submitted. If you'd like to explore this topic further, I can provide:
HL7 recommends that elements with this code be saved for Drug Utilization Reporting (DUR) to track medication usage and safety. 4. Implementation Use Cases
The claim is officially "accepted for payment" rather than denied. 21682 rar
Details on how this code impacts . HL7.TERMINOLOGY\ActCode - FHIR v4.0.1 HL7. TERMINOLOGY\ActCode - FHIR v4. 0.1. HL7 Terminology ActCode - HL7 Terminology (THO) v6.1.0
The invoice element remains nullifiable (reversible) after this adjudication. To trigger internal reviews when a medication claim
To differentiate between fully paid claims and those requiring further financial reconciliation.
To communicate to providers why a payment was lower (or different) than the requested amount. 21681 Adjudicated as Zero Accepted but with a $0 payment
Includes "Adjudicate as zero" or items not covered under a particular policy.