R6 Ballot (2nd Draft)

Publish-box (todo)

Patient Administration icon Work GroupMaturity Level: 1 Trial UseSecurity Category: Patient Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Detailed Descriptions for the elements in the ChargeItem resource.

ChargeItem
Element Id ChargeItem
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 Display Item containing charge code(s) associated with the provision of healthcare provider products
Cardinality 0..*
Type DomainResource
Summary false
ChargeItem.identifier
Element Id ChargeItem.identifier
Definition

Identifiers assigned to this event performer or other systems.

Short Display Business Identifier for item
Note This is a business identifier, not a resource identifier (see discussion)
Cardinality 0..*
Type Identifier
Requirements

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

Summary true
ChargeItem.definitionUri
Element Id ChargeItem.definitionUri
Definition

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

Short Display Defining information about the code of this charge item
Cardinality 0..*
Type uri
Summary false
ChargeItem.definitionCanonical
Element Id ChargeItem.definitionCanonical
Definition

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

Short Display Resource defining the code of this ChargeItem
Cardinality 0..*
Type canonical(ChargeItemDefinition)
Summary false
ChargeItem.status
Element Id ChargeItem.status
Definition

The current state of the ChargeItem.

Short Display planned | billable | not-billable | aborted | billed | entered-in-error | unknown
Cardinality 1..1
Terminology Binding Charge Item Status (Required)
Type code
Is Modifier true (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)
Summary true
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 Id ChargeItem.partOf
Definition

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

Short Display Part of referenced ChargeItem
Cardinality 0..*
Type Reference(ChargeItem)
Hierarchy This reference is part of a strict Hierarchy
Requirements

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

Alternate Names container
Summary false
ChargeItem.code
Element Id ChargeItem.code
Definition

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

Short Display A code that identifies the charge, like a billing code
Cardinality 1..1
Terminology Binding Charge Item Code (Example)
Type CodeableConcept
Alternate Names type
Summary true
ChargeItem.subject
Element Id ChargeItem.subject
Definition

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

Short Display Individual service was done for/to
Cardinality 1..1
Type Reference(Patient | Group)
Requirements

Links the event to the Patient context.

Alternate Names patient
Summary true
ChargeItem.encounter
Element Id ChargeItem.encounter
Definition

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

Short Display Encounter associated with this ChargeItem
Cardinality 0..1
Type Reference(Encounter)
Summary true
Comments

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

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

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

Short Display When the charged service was applied
Cardinality 0..1
Type dateTime|Period|Timing
[x] Note See Choice of Datatypes for further information about how to use [x]
Alternate Names timing
Summary true
Comments

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

ChargeItem.performer
Element Id ChargeItem.performer
Definition

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

Short Display Who performed charged service
Cardinality 0..*
Summary false
ChargeItem.performer.function
Element Id ChargeItem.performer.function
Definition

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

Short Display What type of performance was done
Cardinality 0..1
Terminology Binding Procedure Performer Role Codes (Example)
Type CodeableConcept
Summary false
ChargeItem.performer.actor
Element Id ChargeItem.performer.actor
Definition

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

Short Display Individual who was performing
Cardinality 1..1
Type Reference(Practitioner | PractitionerRole | Organization | HealthcareService | CareTeam | Patient | Device | RelatedPerson)
Summary false
ChargeItem.performingOrganization
Element Id ChargeItem.performingOrganization
Definition

The organization performing the service.

Short Display Organization providing the charged service
Cardinality 0..1
Type Reference(Organization)
Summary false
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 Id ChargeItem.requestingOrganization
Definition

The organization requesting the service.

Short Display Organization requesting the charged service
Cardinality 0..1
Type Reference(Organization)
Summary false
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 Id ChargeItem.costCenter
Definition

The financial cost center permits the tracking of charge attribution.

Short Display Organization that has ownership of the (potential, future) revenue
Cardinality 0..1
Type Reference(Organization)
Summary false
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 Id ChargeItem.quantity
Definition

Quantity of which the charge item has been serviced.

Short Display Quantity of which the charge item has been serviced
Cardinality 0..1
Type Quantity
Summary true
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 Id ChargeItem.bodysite
Definition

The anatomical location where the related service has been applied.

Short Display Anatomical location, if relevant
Cardinality 0..*
Terminology Binding SNOMED CT Body Structures (Example)
Type CodeableConcept
Summary true
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 Id ChargeItem.unitPriceComponent
Definition

The unit price of the chargable item.

Short Display Unit price overriding the associated rules
Cardinality 0..1
Type MonetaryComponent
Summary false
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 Id ChargeItem.totalPriceComponent
Definition

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

Short Display Total price overriding the associated rules
Cardinality 0..1
Type MonetaryComponent
Summary false
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 Id ChargeItem.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 Display Reason for overriding the list price/factor
Cardinality 0..1
Terminology Binding override-reason:
Type CodeableConcept
Summary false
ChargeItem.enterer
Element Id ChargeItem.enterer
Definition

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

Short Display Individual who was entering
Cardinality 0..1
Type Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson)
Summary true
Comments

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

ChargeItem.enteredDate
Element Id ChargeItem.enteredDate
Definition

Date the charge item was entered.

Short Display Date the charge item was entered
Cardinality 0..1
Type dateTime
Summary true
Comments

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

ChargeItem.reason
Element Id ChargeItem.reason
Definition

Describes why the event occurred in coded or textual form.

Short Display Why was the charged service rendered?
Cardinality 0..*
Terminology Binding ICD-10 Codes (Example)
Type CodeableReference(Condition | DiagnosticReport | Observation | ImmunizationRecommendation | Procedure)
Summary false
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 Id ChargeItem.service
Definition

Indicated the rendered service that caused this charge.

Short Display Which rendered service is being charged?
Cardinality 0..*
Type CodeableReference(DiagnosticReport | ImagingStudy | Immunization | MedicationAdministration | MedicationDispense | MedicationRequest | Observation | Procedure | ServiceRequest | SupplyDelivery)
Summary false
ChargeItem.product
Element Id ChargeItem.product
Definition

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

Short Display Product charged
Cardinality 0..*
Terminology Binding Device Type (Example)
Type CodeableReference(Device | Medication | Substance)
Summary false
ChargeItem.account
Element Id ChargeItem.account
Definition

Account into which this ChargeItems belongs.

Short Display Account to place this charge
Cardinality 0..*
Type Reference(Account)
Summary true
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 Id ChargeItem.note
Definition

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

Short Display Comments made about the ChargeItem
Cardinality 0..*
Type Annotation
Summary false
ChargeItem.supportingInformation
Element Id ChargeItem.supportingInformation
Definition

Further information supporting this charge.

Short Display Further information supporting this charge
Cardinality 0..*
Type Reference(Any)
Summary false