R5 Final QA

This page is part of the FHIR Specification (v5.0.0-draft-final: Final QA Preview for R5 - see ballot notes). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

Patient Administration icon Work GroupMaturity Level: 0 Trial UseSecurity Category: Patient Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Detailed Descriptions for the elements in the ChargeItem resource.

ChargeItem
Element IdChargeItem
Definition

The resource ChargeItem describes the provision of healthcare provider products for a certain patient, therefore referring not only to the product, but containing in addition details of the provision, like date, time, amounts and participating organizations and persons. Main Usage of the ChargeItem is to enable the billing process and internal cost allocation.

Short DisplayItem containing charge code(s) associated with the provision of healthcare provider products
Cardinality0..*
TypeDomainResource
Summaryfalse
ChargeItem.identifier
Element IdChargeItem.identifier
Definition

Identifiers assigned to this event performer or other systems.

Short DisplayBusiness Identifier for item
NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Requirements

Allows identification of the charge Item as it is known by various participating systems and in a way that remains consistent across servers.

Summarytrue
ChargeItem.definitionUri
Element IdChargeItem.definitionUri
Definition

References the (external) source of pricing information, rules of application for the code this ChargeItem uses.

Short DisplayDefining information about the code of this charge item
Cardinality0..*
Typeuri
Summaryfalse
ChargeItem.definitionCanonical
Element IdChargeItem.definitionCanonical
Definition

References the source of pricing information, rules of application for the code this ChargeItem uses.

Short DisplayResource defining the code of this ChargeItem
Cardinality0..*
Typecanonical(ChargeItemDefinition)
Summaryfalse
ChargeItem.status
Element IdChargeItem.status
Definition

The current state of the ChargeItem.

Short Displayplanned | billable | not-billable | aborted | billed | entered-in-error | unknown
Cardinality1..1
Terminology BindingCharge Item Status (Required)
Typecode
Is Modifiertrue (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Summarytrue
Comments

Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is.

This element is labeled as a modifier because the status contains the code entered-in-error that marks the charge item as not currently valid.

ChargeItem.partOf
Element IdChargeItem.partOf
Definition

ChargeItems can be grouped to larger ChargeItems covering the whole set.

Short DisplayPart of referenced ChargeItem
Cardinality0..*
TypeReference(ChargeItem)
Requirements

E.g. Drug administration as part of a procedure, procedure as part of observation, etc.

Alternate Namescontainer
Summaryfalse
ChargeItem.code
Element IdChargeItem.code
Definition

A code that identifies the charge, like a billing code.

Short DisplayA code that identifies the charge, like a billing code
Cardinality1..1
Terminology BindingCharge Item Code (Example)
TypeCodeableConcept
Alternate Namestype
Summarytrue
ChargeItem.subject
Element IdChargeItem.subject
Definition

The individual or set of individuals the action is being or was performed on.

Short DisplayIndividual service was done for/to
Cardinality1..1
TypeReference(Patient | Group)
Requirements

Links the event to the Patient context.

Alternate Namespatient
Summarytrue
ChargeItem.encounter
Element IdChargeItem.encounter
Definition

This ChargeItem has the details of how the associated Encounter should be billed or otherwise be handled by finance systems.

Short DisplayEncounter associated with this ChargeItem
Cardinality0..1
TypeReference(Encounter)
Summarytrue
Comments

This ChargeItem may be recorded during planning, execution or after the actual encounter takes place.

ChargeItem.occurrence[x]
Element IdChargeItem.occurrence[x]
Definition

Date/time(s) or duration when the charged service was applied.

Short DisplayWhen the charged service was applied
Cardinality0..1
TypedateTime|Period|Timing
[x] NoteSee Choice of Datatypes for further information about how to use [x]
Alternate Namestiming
Summarytrue
Comments

The list of types may be constrained as appropriate for the type of charge item.

ChargeItem.performer
Element IdChargeItem.performer
Definition

Indicates who or what performed or participated in the charged service.

Short DisplayWho performed charged service
Cardinality0..*
Summaryfalse
ChargeItem.performer.function
Element IdChargeItem.performer.function
Definition

Describes the type of performance or participation(e.g. primary surgeon, anesthesiologiest, etc.).

Short DisplayWhat type of performance was done
Cardinality0..1
Terminology BindingProcedure Performer Role Codes (Example)
TypeCodeableConcept
Summaryfalse
ChargeItem.performer.actor
Element IdChargeItem.performer.actor
Definition

The device, practitioner, etc. who performed or participated in the service.

Short DisplayIndividual who was performing
Cardinality1..1
TypeReference(Practitioner | PractitionerRole | Organization | HealthcareService | CareTeam | Patient | Device | RelatedPerson)
Summaryfalse
ChargeItem.performingOrganization
Element IdChargeItem.performingOrganization
Definition

The organization performing the service.

Short DisplayOrganization providing the charged service
Cardinality0..1
TypeReference(Organization)
Summaryfalse
Comments

Practitioners and Devices can be associated with multiple organizations. It has to be made clear, on behalf of which Organization the services have been rendered.

ChargeItem.requestingOrganization
Element IdChargeItem.requestingOrganization
Definition

The organization requesting the service.

Short DisplayOrganization requesting the charged service
Cardinality0..1
TypeReference(Organization)
Summaryfalse
Comments

The rendered Service might not be associated with a Request. This property indicates which Organization requested the services to be rendered. (In many cases, this may just be the Department associated with the Encounter.location).

ChargeItem.costCenter
Element IdChargeItem.costCenter
Definition

The financial cost center permits the tracking of charge attribution.

Short DisplayOrganization that has ownership of the (potential, future) revenue
Cardinality0..1
TypeReference(Organization)
Summaryfalse
Comments

The costCenter could either be given as a reference to an Organization(Role) resource or as the identifier of the cost center determined by Reference.identifier.value and Reference.identifier.system, depending on use case requirements.

ChargeItem.quantity
Element IdChargeItem.quantity
Definition

Quantity of which the charge item has been serviced.

Short DisplayQuantity of which the charge item has been serviced
Cardinality0..1
TypeQuantity
Summarytrue
Comments

In many cases this may just be a value, if the underlying units are implicit in the definition of the charge item code.

ChargeItem.bodysite
Element IdChargeItem.bodysite
Definition

The anatomical location where the related service has been applied.

Short DisplayAnatomical location, if relevant
Cardinality0..*
Terminology BindingSNOMED CT Body Structures (Example)
TypeCodeableConcept
Summarytrue
Comments

Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension http://hl7.org/fhir/StructureDefinition/bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

ChargeItem.unitPriceComponent
Element IdChargeItem.unitPriceComponent
Definition

The unit price of the chargable item.

Short DisplayUnit price overriding the associated rules
Cardinality0..1
TypeMonetaryComponent
Summaryfalse
Comments

This could be communicated in ChargeItemDefinition. But if ChargeItemDefinition is not supported or not available, the unit price can be communicated in this property.

ChargeItem.totalPriceComponent
Element IdChargeItem.totalPriceComponent
Definition

The total price for the chargable item, accounting for the quantity.

Short DisplayTotal price overriding the associated rules
Cardinality0..1
TypeMonetaryComponent
Summaryfalse
Comments

Often, the total price may be be calculated and recorded on the Invoice, but if a calculated total price must be exchanged prior to Invoice creation, it can be communicated in this property.

ChargeItem.overrideReason
Element IdChargeItem.overrideReason
Definition

If the list price or the rule-based factor associated with the code is overridden, this attribute can capture a text to indicate the reason for this action.

Short DisplayReason for overriding the list price/factor
Cardinality0..1
Terminology Bindingoverride-reason:
TypeCodeableConcept
Summaryfalse
ChargeItem.enterer
Element IdChargeItem.enterer
Definition

The device, practitioner, etc. who entered the charge item.

Short DisplayIndividual who was entering
Cardinality0..1
TypeReference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson)
Summarytrue
Comments

The enterer is also the person considered responsible for factor/price overrides if applicable.

ChargeItem.enteredDate
Element IdChargeItem.enteredDate
Definition

Date the charge item was entered.

Short DisplayDate the charge item was entered
Cardinality0..1
TypedateTime
Summarytrue
Comments

The actual date when the service associated with the charge has been rendered is captured in occurrence[x].

ChargeItem.reason
Element IdChargeItem.reason
Definition

Describes why the event occurred in coded or textual form.

Short DisplayWhy was the charged service rendered?
Cardinality0..*
Terminology BindingICD-10 Codes (Example)
TypeCodeableConcept
Summaryfalse
Comments

If the application of the charge item requires a reason to be given, it can be captured here. Textual reasons can be captured using reasonCode.text.

ChargeItem.service
Element IdChargeItem.service
Definition

Indicated the rendered service that caused this charge.

Short DisplayWhich rendered service is being charged?
Cardinality0..*
TypeCodeableReference(DiagnosticReport | ImagingStudy | Immunization | MedicationAdministration | MedicationDispense | MedicationRequest | Observation | Procedure | ServiceRequest | SupplyDelivery)
Summaryfalse
ChargeItem.product
Element IdChargeItem.product
Definition

Identifies the device, food, drug or other product being charged either by type code or reference to an instance.

Short DisplayProduct charged
Cardinality0..*
Terminology BindingDevice Type (Example)
TypeCodeableReference(Device | Medication | Substance)
Summaryfalse
ChargeItem.account
Element IdChargeItem.account
Definition

Account into which this ChargeItems belongs.

Short DisplayAccount to place this charge
Cardinality0..*
TypeReference(Account)
Summarytrue
Comments

Systems posting the ChargeItems might not always be able to determine, which accounts the Items need to be places into. It is up to the postprocessing Financial System to apply internal rules to decide based on the Encounter/EpisodeOfCare/Patient/Coverage context and the type of ChargeItem, which Account is appropriate.

ChargeItem.note
Element IdChargeItem.note
Definition

Comments made about the event by the performer, subject or other participants.

Short DisplayComments made about the ChargeItem
Cardinality0..*
TypeAnnotation
Summaryfalse
ChargeItem.supportingInformation
Element IdChargeItem.supportingInformation
Definition

Further information supporting this charge.

Short DisplayFurther information supporting this charge
Cardinality0..*
TypeReference(Any)
Summaryfalse