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13.7.28 Resource ClaimResponse - Conversions

Financial Management Work Group

Maturity Level: N/A

Standards Status: Informative

Security Category: N/A

Compartments: N/A

Following are maps for converting between the equivalent R4B resource and this R5 resource.

/// url = 'http://hl7.org/fhir/StructureMap/ClaimResponse5to4'
/// name = 'ClaimResponse5to4'
/// title = 'FML Conversion for ClaimResponse: R5 to R4'
/// status = 'active'

conceptmap "ClaimResponseStatus" {
  prefix s = "http://hl7.org/fhir/fm-status"
  prefix t = "http://hl7.org/fhir/4.0/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/claim-outcome"
  prefix t = "http://hl7.org/fhir/4.0/remittance-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/claim-use"
  prefix t = "http://hl7.org/fhir/4.0/claim-use"

  s:claim - t:claim
  s:preauthorization - t:preauthorization
  s:predetermination - t:predetermination
}

uses "http://hl7.org/fhir/StructureDefinition/ClaimResponse" alias ClaimResponseR5 as source
uses "http://hl7.org/fhir/4.0/StructureDefinition/ClaimResponse" alias ClaimResponseR4 as target

imports "http://hl7.org/fhir/StructureMap/*5to4"

group ClaimResponse(source src : ClaimResponseR5, target tgt : ClaimResponseR4) 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.quantity as s -> tgt then {
    s.value -> tgt.value;
  };
}

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 = s.site;
  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 -> tgt then {
    s.coding as s -> tgt then {
      s.code -> tgt.type;
    };
  };
  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;
}

/// url = 'http://hl7.org/fhir/StructureMap/ClaimResponse5to4B'
/// name = 'ClaimResponse5to4B'
/// title = 'FML Conversion for ClaimResponse: R5 to R4B'
/// status = 'active'

conceptmap "ClaimResponseStatus" {
  prefix s = "http://hl7.org/fhir/fm-status"
  prefix t = "http://hl7.org/fhir/4.3/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/claim-outcome"
  prefix t = "http://hl7.org/fhir/4.3/remittance-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/claim-use"
  prefix t = "http://hl7.org/fhir/4.3/claim-use"

  s:claim - t:claim
  s:preauthorization - t:preauthorization
  s:predetermination - t:predetermination
}

uses "http://hl7.org/fhir/StructureDefinition/ClaimResponse" alias ClaimResponseR5 as source
uses "http://hl7.org/fhir/4.3/StructureDefinition/ClaimResponse" alias ClaimResponseR4B as target

imports "http://hl7.org/fhir/StructureMap/*5to4B"

group ClaimResponse(source src : ClaimResponseR5, target tgt : ClaimResponseR4B) 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.quantity as s -> tgt then {
    s.value -> tgt.value;
  };
}

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 = s.site;
  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 -> tgt then {
    s.coding as s -> tgt then {
      s.code -> tgt.type;
    };
  };
  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;
}

/// url = 'http://hl7.org/fhir/StructureMap/ClaimResponse4Bto5'
/// name = 'ClaimResponse4Bto5'
/// title = 'FML Conversion for ClaimResponse: R4B to R5'
/// status = 'active'

conceptmap "ClaimResponseStatus" {
  prefix s = "http://hl7.org/fhir/4.3/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/4.3/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/4.3/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/4.3/StructureDefinition/ClaimResponse" alias ClaimResponseR4B as source
uses "http://hl7.org/fhir/StructureDefinition/ClaimResponse" alias ClaimResponseR5 as target

imports "http://hl7.org/fhir/StructureMap/*4Bto5"

group ClaimResponse(source src : ClaimResponseR4B, 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;
}

/// 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;
}