Release 4B

This page is part of the FHIR Specification (v4.3.0: R4B - STU). 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

Patient Administration Work GroupMaturity Level: 0 Trial UseSecurity Category: Business Compartments: Not linked to any defined compartments

Detailed Descriptions for the elements in the ChargeItemDefinition resource.

ChargeItemDefinition
Element IdChargeItemDefinition
Definition

The ChargeItemDefinition resource provides the properties that apply to the (billing) codes necessary to calculate costs and prices. The properties may differ largely depending on type and realm, therefore this resource gives only a rough structure and requires profiling for each type of billing code system.

Cardinality0..*
TypeDomainResource
Summaryfalse
Invariants
Defined on this element
cid-0Warning Name should be usable as an identifier for the module by machine processing applications such as code generationname.exists() implies name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
ChargeItemDefinition.url
Element IdChargeItemDefinition.url
Definition

An absolute URI that is used to identify this charge item definition when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this charge item definition is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the charge item definition is stored on different servers.

Cardinality1..1
Typeuri
Requirements

Allows the charge item definition to be referenced by a single globally unique identifier.

Summarytrue
Comments

Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

ChargeItemDefinition.identifier
Element IdChargeItemDefinition.identifier
Definition

A formal identifier that is used to identify this charge item definition when it is represented in other formats, or referenced in a specification, model, design or an instance.

NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Requirements

Allows externally provided and/or usable business identifiers to be easily associated with the module.

Summarytrue
Comments

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this charge item definition outside of FHIR, where it is not possible to use the logical URI.

ChargeItemDefinition.version
Element IdChargeItemDefinition.version
Definition

The identifier that is used to identify this version of the charge item definition when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the charge item definition author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active assets.

NoteThis is a business versionId, not a resource version id (see discussion)
Cardinality0..1
Typestring
Summarytrue
Comments

There may be different charge item definition instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the charge item definition with the format [url]|[version].

ChargeItemDefinition.title
Element IdChargeItemDefinition.title
Definition

A short, descriptive, user-friendly title for the charge item definition.

Cardinality0..1
Typestring
Summarytrue
Comments

This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

ChargeItemDefinition.derivedFromUri
Element IdChargeItemDefinition.derivedFromUri
Definition

The URL pointing to an externally-defined charge item definition that is adhered to in whole or in part by this definition.

Cardinality0..*
Typeuri
Summarytrue
ChargeItemDefinition.partOf
Element IdChargeItemDefinition.partOf
Definition

A larger definition of which this particular definition is a component or step.

Cardinality0..*
Typecanonical(ChargeItemDefinition)
Alternate Namescontainer
Summarytrue
ChargeItemDefinition.replaces
Element IdChargeItemDefinition.replaces
Definition

As new versions of a protocol or guideline are defined, allows identification of what versions are replaced by a new instance.

Cardinality0..*
Typecanonical(ChargeItemDefinition)
Alternate Namessupersedes; prior; renewed order
Summarytrue
ChargeItemDefinition.status
Element IdChargeItemDefinition.status
Definition

The current state of the ChargeItemDefinition.

Cardinality1..1
Terminology BindingPublicationStatus (Required)
Typecode
Is Modifiertrue (Reason: This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration)
Summarytrue
Comments

Allows filtering of charge item definitions that are appropriate for use versus not.

ChargeItemDefinition.experimental
Element IdChargeItemDefinition.experimental
Definition

A Boolean value to indicate that this charge item definition is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

Cardinality0..1
Typeboolean
Requirements

Enables experimental content to be developed following the same lifecycle that would be used for a production-level charge item definition.

Summarytrue
Comments

Allows filtering of charge item definitions that are appropriate for use versus not.

ChargeItemDefinition.date
Element IdChargeItemDefinition.date
Definition

The date (and optionally time) when the charge item definition was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the charge item definition changes.

Cardinality0..1
TypedateTime
Alternate NamesRevision Date
Summarytrue
Comments

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the charge item definition. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

ChargeItemDefinition.publisher
Element IdChargeItemDefinition.publisher
Definition

The name of the organization or individual that published the charge item definition.

Cardinality0..1
Typestring
Requirements

Helps establish the "authority/credibility" of the charge item definition. May also allow for contact.

Summarytrue
Comments

Usually an organization but may be an individual. The publisher (or steward) of the charge item definition is the organization or individual primarily responsible for the maintenance and upkeep of the charge item definition. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the charge item definition. This item SHOULD be populated unless the information is available from context.

ChargeItemDefinition.contact
Element IdChargeItemDefinition.contact
Definition

Contact details to assist a user in finding and communicating with the publisher.

Cardinality0..*
TypeContactDetail
Summarytrue
Comments

May be a web site, an email address, a telephone number, etc.

ChargeItemDefinition.description
Element IdChargeItemDefinition.description
Definition

A free text natural language description of the charge item definition from a consumer's perspective.

Cardinality0..1
Typemarkdown
Summarytrue
Comments

This description can be used to capture details such as why the charge item definition was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the charge item definition as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the charge item definition is presumed to be the predominant language in the place the charge item definition was created).

ChargeItemDefinition.useContext
Element IdChargeItemDefinition.useContext
Definition

The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate charge item definition instances.

Cardinality0..*
TypeUsageContext
Requirements

Assist in searching for appropriate content.

Summarytrue
Comments

When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

ChargeItemDefinition.jurisdiction
Element IdChargeItemDefinition.jurisdiction
Definition

A legal or geographic region in which the charge item definition is intended to be used.

Cardinality0..*
Terminology BindingJurisdiction (Extensible)
TypeCodeableConcept
Summarytrue
Comments

It may be possible for the charge item definition to be used in jurisdictions other than those for which it was originally designed or intended.

ChargeItemDefinition.copyright
Element IdChargeItemDefinition.copyright
Definition

A copyright statement relating to the charge item definition and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the charge item definition.

Cardinality0..1
Typemarkdown
Requirements

Consumers must be able to determine any legal restrictions on the use of the charge item definition and/or its content.

Alternate NamesLicense; Restrictions
Summaryfalse
ChargeItemDefinition.approvalDate
Element IdChargeItemDefinition.approvalDate
Definition

The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

Cardinality0..1
Typedate
Summaryfalse
Comments

The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

ChargeItemDefinition.lastReviewDate
Element IdChargeItemDefinition.lastReviewDate
Definition

The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

Cardinality0..1
Typedate
Requirements

Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

Summaryfalse
Comments

If specified, this date follows the original approval date.

ChargeItemDefinition.effectivePeriod
Element IdChargeItemDefinition.effectivePeriod
Definition

The period during which the charge item definition content was or is planned to be in active use.

Cardinality0..1
TypePeriod
Requirements

Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the charge item definition are or are expected to be used instead.

Summarytrue
Comments

The effective period for a charge item definition determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

ChargeItemDefinition.code
Element IdChargeItemDefinition.code
Definition

The defined billing details in this resource pertain to the given billing code.

Cardinality0..1
Terminology BindingChargeItemCode (Example)
TypeCodeableConcept
Summarytrue
ChargeItemDefinition.instance
Element IdChargeItemDefinition.instance
Definition

The defined billing details in this resource pertain to the given product instance(s).

Cardinality0..*
TypeReference(Medication | Substance | Device)
Summaryfalse
Comments

In case of highly customized, individually produced or fitted devices/substances, the pricing information may be different for each instance of the product. This reference links pricing details to specific product instances.

ChargeItemDefinition.applicability
Element IdChargeItemDefinition.applicability
Definition

Expressions that describe applicability criteria for the billing code.

Cardinality0..*
Summaryfalse
Comments

The applicability conditions can be used to ascertain whether a billing item is allowed in a specific context. E.g. some billing codes may only be applicable in out-patient settings, only to male/female patients or only to children.

ChargeItemDefinition.applicability.description
Element IdChargeItemDefinition.applicability.description
Definition

A brief, natural language description of the condition that effectively communicates the intended semantics.

Cardinality0..1
Typestring
Summaryfalse
ChargeItemDefinition.applicability.language
Element IdChargeItemDefinition.applicability.language
Definition

The media type of the language for the expression, e.g. "text/cql" for Clinical Query Language expressions or "text/fhirpath" for FHIRPath expressions.

Cardinality0..1
Typestring
Summaryfalse
ChargeItemDefinition.applicability.expression
Element IdChargeItemDefinition.applicability.expression
Definition

An expression that returns true or false, indicating whether the condition is satisfied. When using FHIRPath expressions, the %context environment variable must be replaced at runtime with the ChargeItem resource to which this definition is applied.

Cardinality0..1
Typestring
Summaryfalse
Comments

Please note that FHIRPath Expressions can only be evaluated in the scope of the current ChargeItem resource to which this definition is being applied. FHIRPath expressions can traverse into other resources linked from the ChargeItem resource, however, testing rules such as that a billing code may be billed only once per encounter need a wider scope. In such scenarios, CQL may be the appropriate choice.

ChargeItemDefinition.propertyGroup
Element IdChargeItemDefinition.propertyGroup
Definition

Group of properties which are applicable under the same conditions. If no applicability rules are established for the group, then all properties always apply.

Cardinality0..*
Summaryfalse
ChargeItemDefinition.propertyGroup.applicability
Element IdChargeItemDefinition.propertyGroup.applicability
Definition

Expressions that describe applicability criteria for the priceComponent.

Cardinality0..*
TypeSee ChargeItemDefinition.applicability
Summaryfalse
Comments

The applicability conditions can be used to ascertain whether a billing item is allowed in a specific context. E.g. some billing codes may only be applicable in out-patient settings, only to male/female patients or only to children.

ChargeItemDefinition.propertyGroup.priceComponent
Element IdChargeItemDefinition.propertyGroup.priceComponent
Definition

The price for a ChargeItem may be calculated as a base price with surcharges/deductions that apply in certain conditions. A ChargeItemDefinition resource that defines the prices, factors and conditions that apply to a billing code is currently under development. The priceComponent element can be used to offer transparency to the recipient of the Invoice of how the prices have been calculated.

Cardinality0..*
Summaryfalse
ChargeItemDefinition.propertyGroup.priceComponent.type
Element IdChargeItemDefinition.propertyGroup.priceComponent.type
Definition

This code identifies the type of the component.

Cardinality1..1
Terminology BindingInvoicePriceComponentType (Required)
Typecode
Summaryfalse
ChargeItemDefinition.propertyGroup.priceComponent.code
Element IdChargeItemDefinition.propertyGroup.priceComponent.code
Definition

A code that identifies the component. Codes may be used to differentiate between kinds of taxes, surcharges, discounts etc.

Cardinality0..1
TypeCodeableConcept
Summaryfalse
ChargeItemDefinition.propertyGroup.priceComponent.factor
Element IdChargeItemDefinition.propertyGroup.priceComponent.factor
Definition

The factor that has been applied on the base price for calculating this component.

Cardinality0..1
Typedecimal
Summaryfalse
ChargeItemDefinition.propertyGroup.priceComponent.amount
Element IdChargeItemDefinition.propertyGroup.priceComponent.amount
Definition

The amount calculated for this component.

Cardinality0..1
TypeMoney
Summaryfalse