Left: | Prior authorization (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-claimresponse) |
Right: | Prior authorization (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-claimresponse) |
Error | StructureDefinition.version | Values for version differ: '1.0.0' vs '1.1.0-ballot' |
Name | Value | Comments | |
---|---|---|---|
abstract | false | ||
baseDefinition | http://hl7.org/fhir/StructureDefinition/ClaimResponse | ||
copyright | |||
date | 2020-11-09 | ||
description | This profile specifies constraints on ClaimResponse resource to reflect the contents of a pro-active prior authorization returned via a card | ||
experimental | false | ||
fhirVersion | 4.0.1 | ||
jurisdiction | |||
jurisdiction[0] | urn:iso:std:iso:3166#US | ||
kind | resource | ||
name | ClaimResponse | ||
publisher | HL7 International - Financial Management Work Group | ||
purpose | |||
status | draft | ||
title | Prior authorization | ||
type | ClaimResponse | ||
url | http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-claimresponse | ||
version | 1.0.0 | 1.1.0-ballot |
|
Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | L Type | L Description & Constraints | Comments |
---|---|---|---|---|---|---|---|---|---|
ClaimResponse | 0..* | ClaimResponse | Prior authorization | 0..* | ClaimResponse | Prior authorization | |||
id | Σ | 0..1 | string | Logical id of this artifact | Σ | 0..1 | string | Logical id of this artifact | |
meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource | |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created | |
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||
contained | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |
identifier | 0..* | Identifier | Business Identifier for a claim response | 0..* | Identifier | Business Identifier for a claim response | |||
status | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Fixed Value: active | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Fixed Value: active | |
type | SΣ | 1..1 | CodeableConcept | More granular claim type Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim. | SΣ | 1..1 | CodeableConcept | More granular claim type Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim. | |
subType | 0..1 | CodeableConcept | More granular claim type Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode. | 0..1 | CodeableConcept | More granular claim type Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode. | |||
use | SΣ | 1..1 | code | claim | preauthorization | predetermination Binding: Use (required): Claim, preauthorization, predetermination. Fixed Value: preauthorization | SΣ | 1..1 | code | claim | preauthorization | predetermination Binding: Use (required): Claim, preauthorization, predetermination. Fixed Value: preauthorization | |
patient | Σ | 1..1 | Reference(Patient) | The recipient of the products and services | Σ | 1..1 | Reference(Patient) | The recipient of the products and services | |
created | Σ | 1..1 | dateTime | Response creation date | Σ | 1..1 | dateTime | Response creation date | |
insurer | Σ | 1..1 | Reference(Organization) | Party responsible for reimbursement | Σ | 1..1 | Reference(Organization) | Party responsible for reimbursement | |
requestor | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Party responsible for the claim | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Party responsible for the claim | |||
request | Σ | 0..1 | Reference(Claim) | Id of resource triggering adjudication | Σ | 0..1 | Reference(Claim) | Id of resource triggering adjudication | |
outcome | SΣ | 1..1 | code | queued | complete | error | partial Binding: ClaimProcessingCodes (required): The result of the claim processing. Fixed Value: complete | SΣ | 1..1 | code | queued | complete | error | partial Binding: ClaimProcessingCodes (required): The result of the claim processing. Fixed Value: complete | |
disposition | 0..1 | string | Disposition Message | 0..1 | string | Disposition Message | |||
preAuthRef | S | 1..1 | string | Preauthorization reference | S | 1..1 | string | Preauthorization reference | |
preAuthPeriod | S | 0..1 | Period | Preauthorization reference effective period | S | 0..1 | Period | Preauthorization reference effective period | |
payeeType | S | 0..1 | CodeableConcept | Party to be paid any benefits payable Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed. | S | 0..1 | CodeableConcept | Party to be paid any benefits payable Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed. | |
item | 0..* | BackboneElement | Adjudication for claim line items | 0..* | BackboneElement | Adjudication for claim line items | |||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
itemSequence | 1..1 | positiveInt | Claim item instance identifier | 1..1 | positiveInt | Claim item instance identifier | |||
noteNumber | 0..* | positiveInt | Applicable note numbers | 0..* | positiveInt | Applicable note numbers | |||
adjudication | 1..* | BackboneElement | Adjudication details | 1..* | BackboneElement | Adjudication details | |||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
category | 1..1 | CodeableConcept | Type of adjudication information Binding: AdjudicationValueCodes (example): The adjudication codes. | 1..1 | CodeableConcept | Type of adjudication information Binding: AdjudicationValueCodes (example): The adjudication codes. | |||
reason | 0..1 | CodeableConcept | Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | 0..1 | CodeableConcept | Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |||
amount | 0..1 | Money | Monetary amount | 0..1 | Money | Monetary amount | |||
value | 0..1 | decimal | Non-monetary value | 0..1 | decimal | Non-monetary value | |||
detail | 0..* | BackboneElement | Adjudication for claim details | 0..* | BackboneElement | Adjudication for claim details | |||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
detailSequence | 1..1 | positiveInt | Claim detail instance identifier | 1..1 | positiveInt | Claim detail instance identifier | |||
noteNumber | 0..* | positiveInt | Applicable note numbers | 0..* | positiveInt | Applicable note numbers | |||
adjudication | 1..* | See adjudication (ClaimResponse) | Detail level adjudication details | 1..* | See adjudication (ClaimResponse) | Detail level adjudication details | |||
subDetail | 0..* | BackboneElement | Adjudication for claim sub-details | 0..* | BackboneElement | Adjudication for claim sub-details | |||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
subDetailSequence | 1..1 | positiveInt | Claim sub-detail instance identifier | 1..1 | positiveInt | Claim sub-detail instance identifier | |||
noteNumber | 0..* | positiveInt | Applicable note numbers | 0..* | positiveInt | Applicable note numbers | |||
adjudication | 0..* | See adjudication (ClaimResponse) | Subdetail level adjudication details | 0..* | See adjudication (ClaimResponse) | Subdetail level adjudication details | |||
addItem | S | 1..* | BackboneElement | Insurer added line items | S | 1..* | BackboneElement | Insurer added line items | |
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
itemSequence | 0..* | positiveInt | Item sequence number | 0..* | positiveInt | Item sequence number | |||
detailSequence | 0..* | positiveInt | Detail sequence number | 0..* | positiveInt | Detail sequence number | |||
subdetailSequence | 0..* | positiveInt | Subdetail sequence number | 0..* | positiveInt | Subdetail sequence number | |||
provider | S | 0..* | Reference(Practitioner | PractitionerRole | Organization) | Authorized providers | S | 0..* | Reference(Practitioner | PractitionerRole | Organization) | Authorized providers | |
productOrService | S | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | S | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |
modifier | S | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | S | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |
programCode | S | 0..* | CodeableConcept | Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes. | S | 0..* | CodeableConcept | Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes. | |
serviced[x] | 0..1 | date, Period | Date or dates of service or product delivery | 0..1 | date, Period | Date or dates of service or product delivery | |||
location[x] | S | 0..1 | CodeableConcept, Address, Reference(Location) | Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc. | S | 0..1 | CodeableConcept, Address, Reference(Location) | Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc. | |
quantity | S | 0..1 | SimpleQuantity | Count of products or services | S | 0..1 | SimpleQuantity | Count of products or services | |
unitPrice | S | 0..1 | Money | Fee, charge or cost per item | S | 0..1 | Money | Fee, charge or cost per item | |
factor | S | 0..1 | decimal | Price scaling factor | S | 0..1 | decimal | Price scaling factor | |
net | S | 0..1 | Money | Total item cost | S | 0..1 | Money | Total item cost | |
bodySite | S | 0..1 | CodeableConcept | Anatomical location Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch. | S | 0..1 | CodeableConcept | Anatomical location Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch. | |
subSite | S | 0..* | CodeableConcept | Anatomical sub-location Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations. | S | 0..* | CodeableConcept | Anatomical sub-location Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations. | |
noteNumber | S | 0..* | positiveInt | Applicable note numbers | S | 0..* | positiveInt | Applicable note numbers | |
adjudication | S | 1..* | BackboneElement | Added items adjudication | S | 1..* | BackboneElement | Added items adjudication | |
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
category | S | 1..1 | CodeableConcept | Type of adjudication information Binding: AdjudicationValueCodes (example): The adjudication codes. | S | 1..1 | CodeableConcept | Type of adjudication information Binding: AdjudicationValueCodes (example): The adjudication codes. | |
reason | S | 0..1 | CodeableConcept | Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | S | 0..1 | CodeableConcept | Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |
amount | S | 0..1 | Money | Monetary amount | S | 0..1 | Money | Monetary amount | |
value | S | 0..1 | decimal | Non-monetary value | S | 0..1 | decimal | Non-monetary value | |
detail | S | 0..* | BackboneElement | Insurer added line details | S | 0..* | BackboneElement | Insurer added line details | |
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
productOrService | S | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | S | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |
modifier | S | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | S | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |
quantity | S | 0..1 | SimpleQuantity | Count of products or services | S | 0..1 | SimpleQuantity | Count of products or services | |
unitPrice | S | 0..1 | Money | Fee, charge or cost per item | S | 0..1 | Money | Fee, charge or cost per item | |
factor | S | 0..1 | decimal | Price scaling factor | S | 0..1 | decimal | Price scaling factor | |
net | S | 0..1 | Money | Total item cost | S | 0..1 | Money | Total item cost | |
noteNumber | S | 0..* | positiveInt | Applicable note numbers | S | 0..* | positiveInt | Applicable note numbers | |
adjudication | S | 1..* | BackboneElement | Added items detail adjudication | S | 1..* | BackboneElement | Added items detail adjudication | |
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
category | S | 1..1 | CodeableConcept | Type of adjudication information Binding: AdjudicationValueCodes (example): The adjudication codes. | S | 1..1 | CodeableConcept | Type of adjudication information Binding: AdjudicationValueCodes (example): The adjudication codes. | |
reason | S | 0..1 | CodeableConcept | Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | S | 0..1 | CodeableConcept | Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |
amount | S | 0..1 | Money | Monetary amount | S | 0..1 | Money | Monetary amount | |
value | S | 0..1 | decimal | Non-monetary value | S | 0..1 | decimal | Non-monetary value | |
subDetail | S | 0..* | BackboneElement | Insurer added line items | S | 0..* | BackboneElement | Insurer added line items | |
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
productOrService | S | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | S | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |
modifier | S | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | S | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |
quantity | S | 0..1 | SimpleQuantity | Count of products or services | S | 0..1 | SimpleQuantity | Count of products or services | |
unitPrice | S | 0..1 | Money | Fee, charge or cost per item | S | 0..1 | Money | Fee, charge or cost per item | |
factor | S | 0..1 | decimal | Price scaling factor | S | 0..1 | decimal | Price scaling factor | |
net | S | 0..1 | Money | Total item cost | S | 0..1 | Money | Total item cost | |
noteNumber | S | 0..* | positiveInt | Applicable note numbers | S | 0..* | positiveInt | Applicable note numbers | |
adjudication | S | 1..* | BackboneElement | Added items detail adjudication | S | 1..* | BackboneElement | Added items detail adjudication | |
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
category | S | 1..1 | CodeableConcept | Type of adjudication information Binding: AdjudicationValueCodes (example): The adjudication codes. | S | 1..1 | CodeableConcept | Type of adjudication information Binding: AdjudicationValueCodes (example): The adjudication codes. | |
reason | S | 0..1 | CodeableConcept | Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | S | 0..1 | CodeableConcept | Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |
amount | S | 0..1 | Money | Monetary amount | S | 0..1 | Money | Monetary amount | |
value | S | 0..1 | decimal | Non-monetary value | S | 0..1 | decimal | Non-monetary value | |
adjudication | 0..* | See adjudication (ClaimResponse) | Header-level adjudication | 0..* | See adjudication (ClaimResponse) | Header-level adjudication | |||
total | SΣ | 0..* | BackboneElement | Adjudication totals | SΣ | 0..* | BackboneElement | Adjudication totals | |
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
category | SΣ | 1..1 | CodeableConcept | Type of adjudication information Binding: AdjudicationValueCodes (example): The adjudication codes. | SΣ | 1..1 | CodeableConcept | Type of adjudication information Binding: AdjudicationValueCodes (example): The adjudication codes. | |
amount | SΣ | 1..1 | Money | Financial total for the category | SΣ | 1..1 | Money | Financial total for the category | |
payment | 0..0 | 0..0 | |||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
type | 1..1 | CodeableConcept | Partial or complete payment Binding: ExamplePaymentTypeCodes (example): The type (partial, complete) of the payment. | 1..1 | CodeableConcept | Partial or complete payment Binding: ExamplePaymentTypeCodes (example): The type (partial, complete) of the payment. | |||
adjustment | 0..1 | Money | Payment adjustment for non-claim issues | 0..1 | Money | Payment adjustment for non-claim issues | |||
adjustmentReason | 0..1 | CodeableConcept | Explanation for the adjustment Binding: PaymentAdjustmentReasonCodes (example): Payment Adjustment reason codes. | 0..1 | CodeableConcept | Explanation for the adjustment Binding: PaymentAdjustmentReasonCodes (example): Payment Adjustment reason codes. | |||
date | 0..1 | date | Expected date of payment | 0..1 | date | Expected date of payment | |||
amount | 1..1 | Money | Payable amount after adjustment | 1..1 | Money | Payable amount after adjustment | |||
identifier | 0..1 | Identifier | Business identifier for the payment | 0..1 | Identifier | Business identifier for the payment | |||
fundsReserve | S | 0..1 | CodeableConcept | Funds reserved status Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None). | S | 0..1 | CodeableConcept | Funds reserved status Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None). | |
formCode | 0..1 | CodeableConcept | Printed form identifier Binding: Form Codes (example): The forms codes. | 0..1 | CodeableConcept | Printed form identifier Binding: Form Codes (example): The forms codes. | |||
form | 0..1 | Attachment | Printed reference or actual form | 0..1 | Attachment | Printed reference or actual form | |||
processNote | S | 0..* | BackboneElement | Note concerning adjudication | S | 0..* | BackboneElement | Note concerning adjudication | |
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
number | S | 0..1 | positiveInt | Note instance identifier | S | 0..1 | positiveInt | Note instance identifier | |
type | S | 0..1 | code | display | print | printoper Binding: NoteType (required): The presentation types of notes. | S | 0..1 | code | display | print | printoper Binding: NoteType (required): The presentation types of notes. | |
text | S | 1..1 | string | Note explanatory text | S | 1..1 | string | Note explanatory text | |
language | S | 0..1 | CodeableConcept | Language of the text Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | S | 0..1 | CodeableConcept | Language of the text Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |
communicationRequest | 0..* | Reference(CommunicationRequest) | Request for additional information | 0..* | Reference(CommunicationRequest) | Request for additional information | |||
insurance | S | 0..* | BackboneElement | Patient insurance information | S | 0..* | BackboneElement | Patient insurance information | |
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
sequence | S | 1..1 | positiveInt | Insurance instance identifier | S | 1..1 | positiveInt | Insurance instance identifier | |
focal | S | 1..1 | boolean | Coverage to be used for adjudication | S | 1..1 | boolean | Coverage to be used for adjudication | |
coverage | S | 1..1 | Reference(Coverage) | Insurance information | S | 1..1 | Reference(Coverage) | Insurance information | |
businessArrangement | 0..1 | string | Additional provider contract number | 0..1 | string | Additional provider contract number | |||
claimResponse | 0..1 | Reference(ClaimResponse) | Adjudication results | 0..1 | Reference(ClaimResponse) | Adjudication results | |||
error | 0..0 | 0..0 | |||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
itemSequence | 0..1 | positiveInt | Item sequence number | 0..1 | positiveInt | Item sequence number | |||
detailSequence | 0..1 | positiveInt | Detail sequence number | 0..1 | positiveInt | Detail sequence number | |||
subDetailSequence | 0..1 | positiveInt | Subdetail sequence number | 0..1 | positiveInt | Subdetail sequence number | |||
code | 1..1 | CodeableConcept | Error code detailing processing issues Binding: Adjudication Error Codes (example): The adjudication error codes. | 1..1 | CodeableConcept | Error code detailing processing issues Binding: Adjudication Error Codes (example): The adjudication error codes. | |||
Documentation for this format |