This page is part of the FHIR Core Extensions Registry (v5.1.0-ballot: Releases Ballot 4) based on FHIR (HL7® FHIR® Standard) v5.0.0. The current version which supersedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions
Official URL: http://hl7.org/fhir/StructureMap/ClaimResponse4to5 | Version: 5.1.0-ballot1 | |||
Standards status: Trial-use | Maturity Level: 1 | Computable Name: ClaimResponse4to5 |
FMLConversionforClaimResponseR4toR5
/// url = 'http://hl7.org/fhir/StructureMap/ClaimResponse4to5' /// name = 'ClaimResponse4to5' /// title = 'FML Conversion for ClaimResponse: R4 to R5' /// status = 'active' conceptmap "ClaimResponseStatus" { prefix s = "http://hl7.org/fhir/4.0/fm-status" prefix t = "http://hl7.org/fhir/fm-status" s:active - t:active s:cancelled - t:cancelled s:draft - t:draft s:"entered-in-error" - t:"entered-in-error" } conceptmap "RemittanceOutcome" { prefix s = "http://hl7.org/fhir/4.0/remittance-outcome" prefix t = "http://hl7.org/fhir/claim-outcome" s:queued - t:queued s:complete - t:complete s:error - t:error s:partial - t:partial } conceptmap "Use" { prefix s = "http://hl7.org/fhir/4.0/claim-use" prefix t = "http://hl7.org/fhir/claim-use" s:claim - t:claim s:preauthorization - t:preauthorization s:predetermination - t:predetermination } uses "http://hl7.org/fhir/4.0/StructureDefinition/ClaimResponse" alias ClaimResponseR4 as source uses "http://hl7.org/fhir/StructureDefinition/ClaimResponse" alias ClaimResponseR5 as target imports "http://hl7.org/fhir/StructureMap/*4to5" group ClaimResponse(source src : ClaimResponseR4, target tgt : ClaimResponseR5) extends DomainResource <<type+>> { src.identifier -> tgt.identifier; src.status as v -> tgt.status = translate(v, '#ClaimResponseStatus', 'code'); // src.traceNumber -> tgt.traceNumber; src.type -> tgt.type; src.subType -> tgt.subType; src.use as v -> tgt.use = translate(v, '#Use', 'code'); src.patient -> tgt.patient; src.created -> tgt.created; src.insurer -> tgt.insurer; src.requestor -> tgt.requestor; src.request -> tgt.request; src.outcome as v -> tgt.outcome = translate(v, '#RemittanceOutcome', 'code'); src.disposition -> tgt.disposition; // src.decision -> tgt.decision; src.preAuthRef -> tgt.preAuthRef; src.preAuthPeriod -> tgt.preAuthPeriod; src.payeeType -> tgt.payeeType; // src.event as s -> tgt.event as t then ClaimResponseEvent(s,t); src.item as s -> tgt.item as t then ClaimResponseItem(s, t); // src.encounter -> tgt.encounter; src.addItem as s -> tgt.addItem as t then ClaimResponseAddItem(s, t); src.total as s -> tgt.total as t then ClaimResponseTotal(s, t); src.payment as s -> tgt.payment as t then ClaimResponsePayment(s, t); src.fundsReserve -> tgt.fundsReserve; src.formCode -> tgt.formCode; src.form -> tgt.form; src.processNote as s -> tgt.processNote as t then ClaimResponseProcessNote(s, t); src.communicationRequest -> tgt.communicationRequest; src.insurance as s -> tgt.insurance as t then ClaimResponseInsurance(s, t); src.error as s -> tgt.error as t then ClaimResponseError(s, t); } // group ClaimResponseEvent(source src, target tgt) extends BackboneElement { // src.type -> tgt.type; // src.when : dateTime -> tgt.when; // src.when : Period -> tgt.when; // } group ClaimResponseItem(source src, target tgt) extends BackboneElement { src.itemSequence -> tgt.itemSequence; src.noteNumber -> tgt.noteNumber; // src.traceNumber -> tgt.traceNumber; src.adjudication as s -> tgt.adjudication as t then ClaimResponseItemAdjudication(s, t); // src.reviewOutcome as s -> tgt.reviewOutcome as t then ClaimResponseItemReviewOutcome(s,t); src.detail as s -> tgt.detail as t then ClaimResponseItemDetail(s, t); } // group ClaimResponseItemReviewOutcome(source src, target tgt) extends BackboneElement { // src.decision -> tgt.decision; // src.reason -> tgt.reason; // src.preAuthRef -> tgt.preAuthRef; // src.preAuthPeriod -> tgt.preAuthPeriod; // } group ClaimResponseItemAdjudication(source src, target tgt) extends BackboneElement { src.category -> tgt.category; src.reason -> tgt.reason; src.amount -> tgt.amount; src.value as s -> tgt.quantity as t, t.value = s; } group ClaimResponseItemDetail(source src, target tgt) extends BackboneElement { src.detailSequence -> tgt.detailSequence; src.noteNumber -> tgt.noteNumber; // src.traceNumber -> tgt.traceNumber; src.subDetail as s -> tgt.subDetail as t then ClaimResponseItemDetailSubDetail(s, t); } group ClaimResponseItemDetailSubDetail(source src, target tgt) extends BackboneElement { src.subDetailSequence -> tgt.subDetailSequence; src.noteNumber -> tgt.noteNumber; // src.traceNumber -> tgt.traceNumber; } group ClaimResponseAddItem(source src, target tgt) extends BackboneElement { src.itemSequence -> tgt.itemSequence; src.detailSequence -> tgt.detailSequence; src.subdetailSequence -> tgt.subdetailSequence; src.provider -> tgt.provider; // src.traceNumber -> tgt.traceNumber; src.productOrService -> tgt.productOrService; // src.revenue -> tgt.revenue; src.modifier -> tgt.modifier; // src.productOrServiceEnd -> tgt.productOrServiceEnd; src.programCode -> tgt.programCode; src.serviced : date -> tgt.serviced; src.serviced : Period -> tgt.serviced; src.location : CodeableConcept -> tgt.location; src.location : Address -> tgt.location; src.location : Reference -> tgt.location; src.quantity -> tgt.quantity; src.unitPrice -> tgt.unitPrice; src.factor -> tgt.factor; src.net -> tgt.net; // src.tax -> tgt.tax; src.bodySite as s -> tgt.bodySite as t, t.site = s; src.noteNumber -> tgt.noteNumber; src.detail as s -> tgt.detail as t then ClaimResponseAddItemDetail(s, t); } // group ClaimResponseAddItemBodySite(source src, target tgt) extends BackboneElement { // src.site -> tgt.site; // src.subSite -> tgt.subSite; // } group ClaimResponseAddItemDetail(source src, target tgt) extends BackboneElement { src.productOrService -> tgt.productOrService; // src.traceNumber -> tgt.traceNumber; src.modifier -> tgt.modifier; // src.productOrServiceEnd -> tgt.productOrServiceEnd; src.quantity -> tgt.quantity; src.unitPrice -> tgt.unitPrice; src.factor -> tgt.factor; src.net -> tgt.net; // src.tax -> tgt.tax; src.noteNumber -> tgt.noteNumber; src.subDetail as s -> tgt.subDetail as t then ClaimResponseAddItemDetailSubDetail(s, t); } group ClaimResponseAddItemDetailSubDetail(source src, target tgt) extends BackboneElement { src.productOrService -> tgt.productOrService; // src.traceNumber -> tgt.traceNumber; src.modifier -> tgt.modifier; // src.productOrServiceEnd -> tgt.productOrServiceEnd; src.quantity -> tgt.quantity; src.unitPrice -> tgt.unitPrice; src.factor -> tgt.factor; src.net -> tgt.net; // src.tax -> tgt.tax; src.noteNumber -> tgt.noteNumber; } group ClaimResponseTotal(source src, target tgt) extends BackboneElement { src.category -> tgt.category; src.amount -> tgt.amount; } group ClaimResponsePayment(source src, target tgt) extends BackboneElement { src.type -> tgt.type; src.adjustment -> tgt.adjustment; src.adjustmentReason -> tgt.adjustmentReason; src.date -> tgt.date; src.amount -> tgt.amount; src.identifier -> tgt.identifier; } group ClaimResponseProcessNote(source src, target tgt) extends BackboneElement { src.number -> tgt.number; src.type as s where code = 'display' -> tgt.type = create('CodeableConcept') as tc, tc.coding = create('Coding') as tcc, tcc.system = 'http://hl7.org/fhir/note-type', tcc.code = 'display', tcc.display = 'display'; src.type as s where code = 'print' -> tgt.type = create('CodeableConcept') as tc, tc.coding = create('Coding') as tcc, tcc.system = 'http://hl7.org/fhir/note-type', tcc.code = 'print', tcc.display = 'Print (Form)'; src.type as s where code = 'printoper' -> tgt.type = create('CodeableConcept') as tc, tc.coding = create('Coding') as tcc, tcc.system = 'http://hl7.org/fhir/note-type', tcc.code = 'printoper', tcc.display = 'Print (Operator)'; src.text -> tgt.text; src.language -> tgt.language; } group ClaimResponseInsurance(source src, target tgt) extends BackboneElement { src.sequence -> tgt.sequence; src.focal -> tgt.focal; src.coverage -> tgt.coverage; src.businessArrangement -> tgt.businessArrangement; src.claimResponse -> tgt.claimResponse; } group ClaimResponseError(source src, target tgt) extends BackboneElement { src.itemSequence -> tgt.itemSequence; src.detailSequence -> tgt.detailSequence; src.subDetailSequence -> tgt.subDetailSequence; src.code -> tgt.code; }