Profile Comparison between http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional vs http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional

Left:PCT Good Faith Estimate Professional (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional)
Right:PCT Good Faith Estimate Professional (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional)

Messages

ErrorStructureDefinition.versionValues for version differ: '0.1.0' vs '1.0.0'
InformationStructureDefinition.dateValues for date differ: '2021-12-04T21:54:35+00:00' vs '2023-03-30T13:34:22+00:00'
InformationClaim.extensionElement minimum cardinalities differ: '2' vs '1'
InformationClaim.identifierElement minimum cardinalities differ: '0' vs '1'
WarningClaim.patientElements differ in definition for mustSupport: 'true' vs 'false'
WarningClaim.provider.extensionElements differ in short: 'Additional content defined by implementations' vs 'Extension'
WarningClaim.provider.extensionElements differ in definition: 'May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'An Extension'
InformationClaim.provider.extensionElement minimum cardinalities differ: '0' vs '1'
WarningClaim.priorityElements differ in definition for mustSupport: 'true' vs 'false'
WarningClaim.facilityElements differ in definition for mustSupport: 'true' vs 'false'
WarningClaim.careTeam.providerElements differ in definition for mustSupport: 'true' vs 'false'
WarningClaim.careTeam.roleElements differ in definition for mustSupport: 'true' vs 'false'
WarningClaim.careTeam.qualificationElements differ in definition for mustSupport: 'true' vs 'false'
WarningClaim.procedure.extensionElements differ in short: 'Additional content defined by implementations' vs 'Extension'
WarningClaim.procedure.extensionElements differ in definition: 'May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'An Extension'
InformationClaim.procedure.extensionElement minimum cardinalities differ: '0' vs '1'
WarningClaim.insurance.coverageElements differ in definition for mustSupport: 'true' vs 'false'
WarningClaim.insurance.preAuthRefElements differ in definition for mustSupport: 'true' vs 'false'
WarningClaim.itemElements differ in definition for mustSupport: 'true' vs 'false'
InformationClaim.item.extensionElement minimum cardinalities differ: '0' vs '1'
WarningClaim.item.careTeamSequenceElements differ in definition for mustSupport: 'false' vs 'true'
WarningClaim.item.productOrServiceElements differ in comments: 'Must be provided with an actual CPT/HCPCS value. Can’t be null or N/A or data absent reason.' vs 'If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.'
WarningClaim.item.serviced[x]Elements differ in short: 'Date or dates of service or product delivery' vs 'This is the planned or estimated date(s)s of service'
WarningClaim.item.serviced[x]Elements differ in definition: 'The date or dates when the service or product was supplied, performed or completed.' vs 'This is the planned or estimated dates of service. Use Revenue code to determine inpatient stays if needed for adjudication'
WarningClaim.item.serviced[x]Elements differ in definition for mustSupport: 'false' vs 'true'
InformationClaim.item.serviced[x]Element minimum cardinalities differ: '0' vs '1'
WarningClaim.item.quantityElements differ in definition for mustSupport: 'true' vs 'false'
InformationClaim.item.unitPriceElement minimum cardinalities differ: '0' vs '1'
WarningClaim.item.netElements differ in short: 'Total item cost' vs 'Total charge amount for the service line'
WarningClaim.item.netElements differ in definition for mustSupport: 'true' vs 'false'
WarningClaim.item.detail.extensionElements differ in short: 'Extension' vs 'Additional content defined by implementations'
WarningClaim.item.detail.extensionElements differ in definition: 'An Extension' vs 'May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.'

Metadata

NameValueComments
.abstractfalse
    .baseDefinitionhttp://hl7.org/fhir/StructureDefinition/Claim
      .copyright
        .date2021-12-04T21:54:35+00:002023-03-30T13:34:22+00:00
        • Values Differ
        .descriptionPCT Good Faith Estimate Professional is a profile for capturing submission data needed to be processed by a payer for the creation of an Advanced EOB. This profile is used for a professional GFE submission.
          .experimental
            .fhirVersion4.0.1
              .jurisdiction
                ..jurisdiction[0]urn:iso:std:iso:3166#US
                  .kindresource
                    .namePCTGFEProfessional
                      .publisherHL7 International - Financial Management Work Group
                        .purpose
                          .statusactive
                            .titlePCT Good Faith Estimate Professional
                              .typeClaim
                                .urlhttp://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional
                                  .version0.1.01.0.0
                                  • Values Differ

                                  Structure

                                  NameL FlagsL Card.L TypeL Description & ConstraintsR FlagsR Card.L TypeL Description & ConstraintsCommentsdoco
                                  .. Claim 0..*ClaimClaim, Pre-determination or Pre-authorization
                                  0..*ClaimClaim, Pre-determination or Pre-authorization
                                    ... id Σ0..1stringLogical id of this artifactΣ0..1idLogical id of this artifact
                                      ... meta Σ0..1MetaMetadata about the resourceΣ0..1MetaMetadata about the resource
                                        ... implicitRules ?!Σ0..1uriA set of rules under which this content was created?!Σ0..1uriA set of rules under which this content was created
                                          ... language 0..1codeLanguage of the resource content
                                          Binding: ?? (preferred): A human language.

                                          Additional BindingsPurpose
                                          ??Max Binding
                                          0..1codeLanguage of the resource content
                                          Binding: ?? (preferred): A human language.

                                          Additional BindingsPurpose
                                          ??Max Binding
                                            ... text 0..1NarrativeText summary of the resource, for human interpretation0..1NarrativeText summary of the resource, for human interpretation
                                              ... contained 0..*ResourceContained, inline Resources
                                              0..*ResourceContained, inline Resources
                                                ... Slices for extension 2..*ExtensionExtension
                                                Slice: Unordered, Open by value:url
                                                1..*ExtensionExtension
                                                Slice: Unordered, Open by value:url
                                                • Element minimum cardinalities differ: '2' vs '1'
                                                ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
                                                ?!0..*ExtensionExtensions that cannot be ignored
                                                  ... identifier 0..*IdentifierBusiness Identifier for claim
                                                  1..*IdentifierBusiness Identifier for claim
                                                  Slice: Unordered, Open by pattern:type
                                                  • Element minimum cardinalities differ: '0' vs '1'
                                                  ... status ?!Σ1..1codeactive | cancelled | draft | entered-in-error
                                                  Binding: ?? (required): A code specifying the state of the resource instance.

                                                  ?!Σ1..1codeactive | cancelled | draft | entered-in-error
                                                  Binding: ?? (required): A code specifying the state of the resource instance.

                                                    ... type Σ1..1CodeableConceptCategory or discipline
                                                    Binding: ?? (extensible): The type or discipline-style of the claim.


                                                    Required Pattern: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/claim-type","code":"professional","display":"Professional"}]}
                                                    Σ1..1CodeableConceptCategory or discipline
                                                    Binding: ?? (extensible): The type or discipline-style of the claim.


                                                    Required Pattern: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/claim-type","code":"professional"}]}
                                                      ... subType 0..1CodeableConceptMore granular claim type
                                                      Binding: ?? (example): A more granular claim typecode.

                                                      0..1CodeableConceptMore granular claim type
                                                      Binding: ?? (example): A more granular claim typecode.

                                                        ... use Σ1..1codeclaim | preauthorization | predetermination
                                                        Binding: ?? (required): The purpose of the Claim: predetermination, preauthorization, claim.


                                                        Required Pattern: predetermination
                                                        Σ1..1codeclaim | preauthorization | predetermination
                                                        Binding: ?? (required): The purpose of the Claim: predetermination, preauthorization, claim.


                                                        Required Pattern: predetermination
                                                          ... patient SΣ1..1Reference(PCT Patient)The recipient of the products and servicesΣ1..1Reference(HRex Patient Demographics)The recipient of the products and services
                                                          • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                          ... billablePeriod Σ0..1PeriodRelevant time frame for the claimΣ0..1PeriodRelevant time frame for the claim
                                                            ... created Σ1..1dateTimeResource creation dateΣ1..1dateTimeResource creation date
                                                              ... enterer 0..1Reference(Practitioner | PractitionerRole)Author of the claim0..1Reference(Practitioner | PractitionerRole)Author of the claim
                                                                ... insurer Σ1..1Reference(PCT Organization)TargetΣ1..1Reference(PCT Organization)Target
                                                                  ... provider Σ1..1Reference(PCT Organization | PCT PractitionerRole)Billing provider - party responsible for the GFEΣ1..1Reference(PCT Organization | PCT Practitioner)Billing provider - party responsible for the GFE
                                                                    .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                      .... Slices for extension 0..*ExtensionAdditional content defined by implementations
                                                                      Slice: Unordered, Open by value:url
                                                                      1..*ExtensionExtension
                                                                      Slice: Unordered, Open by value:url
                                                                      • Elements differ in short: 'Additional content defined by implementations' vs 'Extension'
                                                                      • Elements differ in definition: 'May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'An Extension'
                                                                      • Element minimum cardinalities differ: '0' vs '1'
                                                                      .... reference ΣC0..1stringLiteral reference, Relative, internal or absolute URLΣC0..1stringLiteral reference, Relative, internal or absolute URL
                                                                        .... type Σ0..1uriType the reference refers to (e.g. "Patient")
                                                                        Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).

                                                                        Σ0..1uriType the reference refers to (e.g. "Patient")
                                                                        Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).

                                                                          .... identifier Σ0..1IdentifierLogical reference, when literal reference is not knownΣ0..1IdentifierLogical reference, when literal reference is not known
                                                                            .... display Σ0..1stringText alternative for the resourceΣ0..1stringText alternative for the resource
                                                                              ... priority SΣ1..1CodeableConceptDesired processing ugency
                                                                              Binding: ?? (required)
                                                                              Σ1..1CodeableConceptDesired processing ugency
                                                                              Binding: ?? (required)
                                                                              • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                                              ... fundsReserve 0..1CodeableConceptFor whom to reserve funds
                                                                              Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None).

                                                                              0..1CodeableConceptFor whom to reserve funds
                                                                              Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None).

                                                                                ... related 0..*BackboneElementPrior or corollary claims
                                                                                0..*BackboneElementPrior or corollary claims
                                                                                  .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                    .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                    0..*ExtensionAdditional content defined by implementations
                                                                                      .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                      ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                        .... claim 0..1Reference(Claim)Reference to the related claim0..1Reference(Claim)Reference to the related claim
                                                                                          .... relationship 0..1CodeableConceptHow the reference claim is related
                                                                                          Binding: ?? (example): Relationship of this claim to a related Claim.

                                                                                          0..1CodeableConceptHow the reference claim is related
                                                                                          Binding: ?? (example): Relationship of this claim to a related Claim.

                                                                                            .... reference 0..1IdentifierFile or case reference0..1IdentifierFile or case reference
                                                                                              ... prescription 0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Prescription authorizing services and products0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Prescription authorizing services and products
                                                                                                ... originalPrescription 0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Original prescription if superseded by fulfiller0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Original prescription if superseded by fulfiller
                                                                                                  ... payee S0..1BackboneElementRecipient of benefits payableS0..1BackboneElementRecipient of benefits payable
                                                                                                    .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                      .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                      0..*ExtensionAdditional content defined by implementations
                                                                                                        .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                        ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                          .... type 1..1CodeableConceptCategory of recipient
                                                                                                          Binding: ?? (example): A code for the party to be reimbursed.

                                                                                                          1..1CodeableConceptCategory of recipient
                                                                                                          Binding: ?? (example): A code for the party to be reimbursed.

                                                                                                            .... party 0..1Reference(PCT Practitioner | PCT Organization)Recipient reference0..1Reference(PCT Practitioner | PCT Organization)Recipient reference
                                                                                                              ... referral 0..1Reference(ServiceRequest)Treatment referral0..1Reference(ServiceRequest)Treatment referral
                                                                                                                .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                  .... Slices for extension 1..*ExtensionExtension
                                                                                                                  Slice: Unordered, Open by value:url
                                                                                                                  1..*ExtensionExtension
                                                                                                                  Slice: Unordered, Open by value:url
                                                                                                                    .... reference ΣC0..1stringLiteral reference, Relative, internal or absolute URLΣC0..1stringLiteral reference, Relative, internal or absolute URL
                                                                                                                      .... type Σ0..1uriType the reference refers to (e.g. "Patient")
                                                                                                                      Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).

                                                                                                                      Σ0..1uriType the reference refers to (e.g. "Patient")
                                                                                                                      Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).

                                                                                                                        .... identifier Σ0..1IdentifierLogical reference, when literal reference is not knownΣ0..1IdentifierLogical reference, when literal reference is not known
                                                                                                                          .... display Σ0..1stringText alternative for the resourceΣ0..1stringText alternative for the resource
                                                                                                                            ... facility S0..1Reference(PCT Location)Servicing facility0..1Reference(Location)Servicing facility
                                                                                                                            • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                                                                                            ... Slices for careTeam S0..*BackboneElementMembers of the care team
                                                                                                                            Slice: Unordered, Open by pattern:role
                                                                                                                            S0..*BackboneElementMembers of the care team
                                                                                                                            Slice: Unordered, Open by pattern:role
                                                                                                                              .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                0..*ExtensionAdditional content defined by implementations
                                                                                                                                  .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                  ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                    .... sequence 1..1positiveIntOrder of care team1..1positiveIntOrder of care team
                                                                                                                                      .... provider S1..1Reference(PCT Practitioner | PCT Organization)Practitioner or organization1..1Reference(PCT Practitioner | PCT Organization)Practitioner or organization
                                                                                                                                      • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                                                                                                      .... responsible 0..1booleanIndicator of the lead practitioner0..1booleanIndicator of the lead practitioner
                                                                                                                                        .... role S1..1CodeableConceptFunction within the team
                                                                                                                                        Binding: ?? (required)
                                                                                                                                        1..1CodeableConceptFunction within the team
                                                                                                                                        Binding: ?? (required)
                                                                                                                                        • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                                                                                                        .... qualification S0..1CodeableConceptPractitioner credential or specialization
                                                                                                                                        Binding: ?? (required)
                                                                                                                                        0..1CodeableConceptPractitioner credential or specialization
                                                                                                                                        Binding: ?? (required)
                                                                                                                                        • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                                                                                                        ... Slices for supportingInfo S0..*BackboneElementSupporting information
                                                                                                                                        Slice: Unordered, Open by pattern:category
                                                                                                                                        S0..*BackboneElementSupporting information
                                                                                                                                        Slice: Unordered, Open by pattern:category
                                                                                                                                          .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                            .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                            0..*ExtensionAdditional content defined by implementations
                                                                                                                                              .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                              ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                .... sequence 1..1positiveIntInformation instance identifier1..1positiveIntInformation instance identifier
                                                                                                                                                  .... category 1..1CodeableConceptClassification of the supplied information
                                                                                                                                                  Binding: ?? (extensible)
                                                                                                                                                  1..1CodeableConceptClassification of the supplied information
                                                                                                                                                  Binding: ?? (extensible)
                                                                                                                                                    .... code 0..1CodeableConceptType of information
                                                                                                                                                    Binding: ?? (example): The valuset used for additional information codes.

                                                                                                                                                    0..1CodeableConceptType of information
                                                                                                                                                    Binding: ?? (example): The valuset used for additional information codes.

                                                                                                                                                      .... timing[x] 0..1date, PeriodWhen it occurred0..1date, PeriodWhen it occurred
                                                                                                                                                        .... value[x] 0..1boolean, string, Quantity, Attachment, Reference(Resource)Data to be provided0..1boolean, string, Quantity, Attachment, Reference(Resource)Data to be provided
                                                                                                                                                          .... reason 0..1CodeableConceptExplanation for the information
                                                                                                                                                          Binding: ?? (example): Reason codes for the missing teeth.

                                                                                                                                                          0..1CodeableConceptExplanation for the information
                                                                                                                                                          Binding: ?? (example): Reason codes for the missing teeth.

                                                                                                                                                            ... Slices for diagnosis S1..*BackboneElementPertinent diagnosis information
                                                                                                                                                            Slice: Unordered, Open by pattern:type
                                                                                                                                                            S1..*BackboneElementPertinent diagnosis information
                                                                                                                                                            Slice: Unordered, Open by pattern:type
                                                                                                                                                              .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                  .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                  ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                    .... sequence 1..1positiveIntDiagnosis instance identifier1..1positiveIntDiagnosis instance identifier
                                                                                                                                                                      .... diagnosis[x] 1..1CodeableConcept, Reference(Condition)Nature of illness or problem
                                                                                                                                                                      Binding: ?? (example): Example ICD10 Diagnostic codes.

                                                                                                                                                                      1..1CodeableConcept, Reference(Condition)Nature of illness or problem
                                                                                                                                                                      Binding: ?? (example): Example ICD10 Diagnostic codes.

                                                                                                                                                                        .... type S0..*CodeableConceptTiming or nature of the diagnosis
                                                                                                                                                                        Binding: ?? (required)
                                                                                                                                                                        S0..*CodeableConceptTiming or nature of the diagnosis
                                                                                                                                                                        Binding: ?? (required)
                                                                                                                                                                          .... onAdmission 0..1CodeableConceptPresent on admission
                                                                                                                                                                          Binding: ?? (example): Present on admission.

                                                                                                                                                                          0..1CodeableConceptPresent on admission
                                                                                                                                                                          Binding: ?? (example): Present on admission.

                                                                                                                                                                            .... packageCode 0..1CodeableConceptPackage billing code
                                                                                                                                                                            Binding: ?? (example): The DRG codes associated with the diagnosis.

                                                                                                                                                                            0..1CodeableConceptPackage billing code
                                                                                                                                                                            Binding: ?? (example): The DRG codes associated with the diagnosis.

                                                                                                                                                                              ... Slices for procedure S0..*BackboneElementClinical procedures performed
                                                                                                                                                                              Slice: Unordered, Open by pattern:type
                                                                                                                                                                              S0..*BackboneElementClinical procedures performed
                                                                                                                                                                              Slice: Unordered, Open by pattern:type
                                                                                                                                                                                .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                  .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                  1..*ExtensionExtension
                                                                                                                                                                                  Slice: Unordered, Open by value:url
                                                                                                                                                                                  • Elements differ in short: 'Additional content defined by implementations' vs 'Extension'
                                                                                                                                                                                  • Elements differ in definition: 'May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'An Extension'
                                                                                                                                                                                  • Element minimum cardinalities differ: '0' vs '1'
                                                                                                                                                                                  .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                  ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                    .... sequence 1..1positiveIntProcedure instance identifier1..1positiveIntProcedure instance identifier
                                                                                                                                                                                      .... type S0..*CodeableConceptCategory of Procedure
                                                                                                                                                                                      Binding: ?? (required)
                                                                                                                                                                                      S0..*CodeableConceptCategory of Procedure
                                                                                                                                                                                      Binding: ?? (required)
                                                                                                                                                                                        .... date 0..1dateTimeWhen the procedure was performed0..1dateTimeWhen the procedure was performed
                                                                                                                                                                                          .... procedure[x] 1..1CodeableConcept, Reference(Procedure)Specific clinical procedure
                                                                                                                                                                                          Binding: ?? (example): Example ICD10 Procedure codes.

                                                                                                                                                                                          1..1CodeableConcept, Reference(Procedure)Specific clinical procedure
                                                                                                                                                                                          Binding: ?? (example): Example ICD10 Procedure codes.

                                                                                                                                                                                            .... udi 0..*Reference(Device)Unique device identifier
                                                                                                                                                                                            0..*Reference(Device)Unique device identifier
                                                                                                                                                                                              ... insurance Σ1..*BackboneElementPatient insurance information
                                                                                                                                                                                              Σ1..*BackboneElementPatient insurance information
                                                                                                                                                                                                .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                  .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                  0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                    ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                      .... sequence Σ1..1positiveIntInsurance instance identifierΣ1..1positiveIntInsurance instance identifier
                                                                                                                                                                                                        .... focal Σ1..1booleanCoverage to be used for adjudicationΣ1..1booleanCoverage to be used for adjudication
                                                                                                                                                                                                          .... identifier 0..1IdentifierPre-assigned Claim number0..1IdentifierPre-assigned Claim number
                                                                                                                                                                                                            .... coverage SΣ1..1Reference(PCT Coverage)Insurance informationΣ1..1Reference(PCT Coverage)Insurance information
                                                                                                                                                                                                            • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                                                                                                                                                                            .... businessArrangement 0..1stringAdditional provider contract number0..1stringAdditional provider contract number
                                                                                                                                                                                                              .... preAuthRef S0..2stringPrior authorization reference number
                                                                                                                                                                                                              0..2stringPrior authorization reference number
                                                                                                                                                                                                              • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                                                                                                                                                                              .... claimResponse 0..1Reference(ClaimResponse)Adjudication results0..1Reference(ClaimResponse)Adjudication results
                                                                                                                                                                                                                ... accident 0..1BackboneElementDetails of the event0..1BackboneElementDetails of the event
                                                                                                                                                                                                                  .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                    .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                    0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                      .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                      ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                        .... date 1..1dateWhen the incident occurred1..1dateWhen the incident occurred
                                                                                                                                                                                                                          .... type 0..1CodeableConceptThe nature of the accident
                                                                                                                                                                                                                          Binding: ?? (extensible): Type of accident: work place, auto, etc.

                                                                                                                                                                                                                          0..1CodeableConceptThe nature of the accident
                                                                                                                                                                                                                          Binding: ?? (extensible): Type of accident: work place, auto, etc.

                                                                                                                                                                                                                            .... location[x] 0..1Address, Reference(Location)Where the event occurred0..1AddressWhere the event occurred
                                                                                                                                                                                                                              ..... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                ..... Slices for extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                Slice: Unordered, Open by value:url
                                                                                                                                                                                                                                0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                Slice: Unordered, Open by value:url
                                                                                                                                                                                                                                  ..... use ?!Σ0..1codehome | work | temp | old | billing - purpose of this address
                                                                                                                                                                                                                                  Binding: ?? (required): The use of an address.


                                                                                                                                                                                                                                  Example General: home
                                                                                                                                                                                                                                  ?!Σ0..1codehome | work | temp | old | billing - purpose of this address
                                                                                                                                                                                                                                  Binding: ?? (required): The use of an address.


                                                                                                                                                                                                                                  Example General: home
                                                                                                                                                                                                                                    ..... type Σ0..1codepostal | physical | both
                                                                                                                                                                                                                                    Binding: ?? (required): The type of an address (physical / postal).


                                                                                                                                                                                                                                    Example General: both
                                                                                                                                                                                                                                    Σ0..1codepostal | physical | both
                                                                                                                                                                                                                                    Binding: ?? (required): The type of an address (physical / postal).


                                                                                                                                                                                                                                    Example General: both
                                                                                                                                                                                                                                      ..... text Σ0..1stringText representation of the address
                                                                                                                                                                                                                                      Example General: 137 Nowhere Street, Erewhon 9132
                                                                                                                                                                                                                                      Σ0..1stringText representation of the address
                                                                                                                                                                                                                                      Example General: 137 Nowhere Street, Erewhon 9132
                                                                                                                                                                                                                                        ..... line Σ0..*stringStreet name, number, direction & P.O. Box etc.
                                                                                                                                                                                                                                        This repeating element order: The order in which lines should appear in an address label
                                                                                                                                                                                                                                        Example General: 137 Nowhere Street
                                                                                                                                                                                                                                        Σ0..*stringStreet name, number, direction & P.O. Box etc.
                                                                                                                                                                                                                                        This repeating element order: The order in which lines should appear in an address label
                                                                                                                                                                                                                                        Example General: 137 Nowhere Street
                                                                                                                                                                                                                                          ..... city Σ0..1stringName of city, town etc.
                                                                                                                                                                                                                                          Example General: Erewhon
                                                                                                                                                                                                                                          Σ0..1stringName of city, town etc.
                                                                                                                                                                                                                                          Example General: Erewhon
                                                                                                                                                                                                                                            ..... district Σ0..1stringDistrict name (aka county)
                                                                                                                                                                                                                                            Example General: Madison
                                                                                                                                                                                                                                            Σ0..1stringDistrict name (aka county)
                                                                                                                                                                                                                                            Example General: Madison
                                                                                                                                                                                                                                              ..... state Σ0..1stringSub-unit of country (abbreviations ok)Σ0..1stringSub-unit of country (abbreviations ok)
                                                                                                                                                                                                                                                ..... postalCode Σ0..1stringPostal code for area
                                                                                                                                                                                                                                                Example General: 9132
                                                                                                                                                                                                                                                Σ0..1stringPostal code for area
                                                                                                                                                                                                                                                Example General: 9132
                                                                                                                                                                                                                                                  ..... country Σ0..1stringCountry (e.g. can be ISO 3166 2 or 3 letter code)Σ0..1stringCountry (e.g. can be ISO 3166 2 or 3 letter code)
                                                                                                                                                                                                                                                  Binding: ?? (required)
                                                                                                                                                                                                                                                    ..... period Σ0..1PeriodTime period when address was/is in use
                                                                                                                                                                                                                                                    Example General: {"start":"2010-03-23","end":"2010-07-01"}
                                                                                                                                                                                                                                                    Σ0..1PeriodTime period when address was/is in use
                                                                                                                                                                                                                                                    Example General: {"start":"2010-03-23","end":"2010-07-01"}
                                                                                                                                                                                                                                                      ... item S1..50BackboneElementProduct or service provided
                                                                                                                                                                                                                                                      1..50BackboneElementProduct or service provided
                                                                                                                                                                                                                                                      • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                                                                                                                                                                                                                      .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                        .... Slices for extension 0..*ExtensionExtension
                                                                                                                                                                                                                                                        Slice: Unordered, Open by value:url
                                                                                                                                                                                                                                                        1..*ExtensionExtension
                                                                                                                                                                                                                                                        Slice: Unordered, Open by value:url
                                                                                                                                                                                                                                                        • Element minimum cardinalities differ: '0' vs '1'
                                                                                                                                                                                                                                                        .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                        ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                          .... sequence 1..1positiveIntItem instance identifier1..1positiveIntItem instance identifier
                                                                                                                                                                                                                                                            .... careTeamSequence 0..*positiveIntApplicable careTeam members
                                                                                                                                                                                                                                                            S0..*positiveIntApplicable careTeam members
                                                                                                                                                                                                                                                            • Elements differ in definition for mustSupport: 'false' vs 'true'
                                                                                                                                                                                                                                                            .... diagnosisSequence 0..*positiveIntApplicable diagnoses
                                                                                                                                                                                                                                                            0..*positiveIntApplicable diagnoses
                                                                                                                                                                                                                                                              .... procedureSequence 0..*positiveIntApplicable procedures
                                                                                                                                                                                                                                                              0..*positiveIntApplicable procedures
                                                                                                                                                                                                                                                                .... informationSequence 0..*positiveIntApplicable exception and supporting information
                                                                                                                                                                                                                                                                0..*positiveIntApplicable exception and supporting information
                                                                                                                                                                                                                                                                  .... revenue 0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                  Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.

                                                                                                                                                                                                                                                                  0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                  Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.

                                                                                                                                                                                                                                                                    .... category 0..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                    Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.

                                                                                                                                                                                                                                                                    0..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                    Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.

                                                                                                                                                                                                                                                                      .... productOrService 1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                      Binding: ?? (required)
                                                                                                                                                                                                                                                                      1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                      Binding: ?? (required)
                                                                                                                                                                                                                                                                      • Elements differ in comments: 'Must be provided with an actual CPT/HCPCS value. Can’t be null or N/A or data absent reason.' vs 'If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.'
                                                                                                                                                                                                                                                                      .... modifier S0..4CodeableConceptProduct or service billing modifiers
                                                                                                                                                                                                                                                                      Binding: ?? (required)
                                                                                                                                                                                                                                                                      S0..4CodeableConceptProduct or service billing modifiers
                                                                                                                                                                                                                                                                      Binding: ?? (required)
                                                                                                                                                                                                                                                                        .... programCode 0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                        Binding: ?? (example): Program specific reason codes.


                                                                                                                                                                                                                                                                        0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                        Binding: ?? (example): Program specific reason codes.


                                                                                                                                                                                                                                                                          .... serviced[x] 0..1date, PeriodDate or dates of service or product deliveryS1..1date, PeriodThis is the planned or estimated date(s)s of service
                                                                                                                                                                                                                                                                          • Elements differ in short: 'Date or dates of service or product delivery' vs 'This is the planned or estimated date(s)s of service'
                                                                                                                                                                                                                                                                          • Elements differ in definition: 'The date or dates when the service or product was supplied, performed or completed.' vs 'This is the planned or estimated dates of service. Use Revenue code to determine inpatient stays if needed for adjudication'
                                                                                                                                                                                                                                                                          • Elements differ in definition for mustSupport: 'false' vs 'true'
                                                                                                                                                                                                                                                                          • Element minimum cardinalities differ: '0' vs '1'
                                                                                                                                                                                                                                                                          .... Slices for location[x] 1..1CodeableConceptPlace of service or where product was supplied
                                                                                                                                                                                                                                                                          Slice: Unordered, Closed by type:$this
                                                                                                                                                                                                                                                                          Binding: ?? (example): Place of service: pharmacy, school, prison, etc.

                                                                                                                                                                                                                                                                          1..1CodeableConceptPlace of service or where product was supplied
                                                                                                                                                                                                                                                                          Slice: Unordered, Closed by type:$this
                                                                                                                                                                                                                                                                          Binding: ?? (example): Place of service: pharmacy, school, prison, etc.

                                                                                                                                                                                                                                                                            .... quantity S1..1??Count of products or services1..1??Count of products or services
                                                                                                                                                                                                                                                                            • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                                                                                                                                                                                                                                            .... unitPrice 0..1MoneyFee, charge or cost per item1..1MoneyFee, charge or cost per item
                                                                                                                                                                                                                                                                            • Element minimum cardinalities differ: '0' vs '1'
                                                                                                                                                                                                                                                                            .... factor 0..1decimalPrice scaling factor0..1decimalPrice scaling factor
                                                                                                                                                                                                                                                                              .... net S1..1MoneyTotal item cost1..1MoneyTotal charge amount for the service line
                                                                                                                                                                                                                                                                              • Elements differ in short: 'Total item cost' vs 'Total charge amount for the service line'
                                                                                                                                                                                                                                                                              • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                                                                                                                                                                                                                                              .... udi 0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                              0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                                .... bodySite 0..1CodeableConceptAnatomical location
                                                                                                                                                                                                                                                                                Binding: ?? (example): The code for the teeth, quadrant, sextant and arch.

                                                                                                                                                                                                                                                                                0..1CodeableConceptAnatomical location
                                                                                                                                                                                                                                                                                Binding: ?? (example): The code for the teeth, quadrant, sextant and arch.

                                                                                                                                                                                                                                                                                  .... subSite 0..*CodeableConceptAnatomical sub-location
                                                                                                                                                                                                                                                                                  Binding: ?? (example): The code for the tooth surface and surface combinations.


                                                                                                                                                                                                                                                                                  0..*CodeableConceptAnatomical sub-location
                                                                                                                                                                                                                                                                                  Binding: ?? (example): The code for the tooth surface and surface combinations.


                                                                                                                                                                                                                                                                                    .... encounter 0..*Reference(Encounter)Encounters related to this billed item
                                                                                                                                                                                                                                                                                    0..*Reference(Encounter)Encounters related to this billed item
                                                                                                                                                                                                                                                                                      .... detail S0..*BackboneElementDrug Identification Information
                                                                                                                                                                                                                                                                                      S0..*BackboneElementDrug Identification Information
                                                                                                                                                                                                                                                                                        ..... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                          ..... Slices for extension 0..*ExtensionExtension
                                                                                                                                                                                                                                                                                          Slice: Unordered, Open by value:url
                                                                                                                                                                                                                                                                                          0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                          • Elements differ in short: 'Extension' vs 'Additional content defined by implementations'
                                                                                                                                                                                                                                                                                          • Elements differ in definition: 'An Extension' vs 'May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.'
                                                                                                                                                                                                                                                                                          ..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                          ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                            ..... sequence 1..1positiveIntItem instance identifier1..1positiveIntItem instance identifier
                                                                                                                                                                                                                                                                                              ..... revenue 0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                                              Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.

                                                                                                                                                                                                                                                                                              0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                                              Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.

                                                                                                                                                                                                                                                                                                ..... category 0..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                                                Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.

                                                                                                                                                                                                                                                                                                0..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                                                Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.

                                                                                                                                                                                                                                                                                                  ..... productOrService 1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                  Binding: ?? (required)
                                                                                                                                                                                                                                                                                                  1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                  Binding: ?? (required)
                                                                                                                                                                                                                                                                                                    ..... modifier 0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                                                                                                                                                    Binding: ?? (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.


                                                                                                                                                                                                                                                                                                    0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                                                                                                                                                    Binding: ?? (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 0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                                                      Binding: ?? (example): Program specific reason codes.


                                                                                                                                                                                                                                                                                                      0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                                                      Binding: ?? (example): Program specific reason codes.


                                                                                                                                                                                                                                                                                                        ..... quantity S0..1??Count of products or servicesS0..1??Count of products or services
                                                                                                                                                                                                                                                                                                          ..... unitPrice 0..1MoneyFee, charge or cost per item0..1MoneyFee, charge or cost per item
                                                                                                                                                                                                                                                                                                            ..... factor 0..1decimalPrice scaling factor0..1decimalPrice scaling factor
                                                                                                                                                                                                                                                                                                              ..... net 0..1MoneyTotal item cost0..1MoneyTotal item cost
                                                                                                                                                                                                                                                                                                                ..... udi 0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                                                                0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                                                                  ..... subDetail 0..*BackboneElementProduct or service provided
                                                                                                                                                                                                                                                                                                                  0..*BackboneElementProduct or service provided
                                                                                                                                                                                                                                                                                                                    ...... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                                      ...... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                      0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                                        ...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                        ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                                          ...... sequence 1..1positiveIntItem instance identifier1..1positiveIntItem instance identifier
                                                                                                                                                                                                                                                                                                                            ...... revenue 0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                                                                            Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.

                                                                                                                                                                                                                                                                                                                            0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                                                                            Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.

                                                                                                                                                                                                                                                                                                                              ...... category 0..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                                                                              Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.

                                                                                                                                                                                                                                                                                                                              0..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                                                                              Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.

                                                                                                                                                                                                                                                                                                                                ...... productOrService 1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                                                Binding: ?? (example): Allowable service and product codes.

                                                                                                                                                                                                                                                                                                                                1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                                                Binding: ?? (example): Allowable service and product codes.

                                                                                                                                                                                                                                                                                                                                  ...... modifier 0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                                                                                                                                                                                  Binding: ?? (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.


                                                                                                                                                                                                                                                                                                                                  0..*CodeableConceptService/Product billing modifiers
                                                                                                                                                                                                                                                                                                                                  Binding: ?? (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 0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                                                                                    Binding: ?? (example): Program specific reason codes.


                                                                                                                                                                                                                                                                                                                                    0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                                                                                    Binding: ?? (example): Program specific reason codes.


                                                                                                                                                                                                                                                                                                                                      ...... quantity 0..1??Count of products or services0..1??Count of products or services
                                                                                                                                                                                                                                                                                                                                        ...... unitPrice 0..1MoneyFee, charge or cost per item0..1MoneyFee, charge or cost per item
                                                                                                                                                                                                                                                                                                                                          ...... factor 0..1decimalPrice scaling factor0..1decimalPrice scaling factor
                                                                                                                                                                                                                                                                                                                                            ...... net 0..1MoneyTotal item cost0..1MoneyTotal item cost
                                                                                                                                                                                                                                                                                                                                              ...... udi 0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                                                                                              0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                                                                                                ... total 1..1MoneyTotal GFE Charges Submitted1..1MoneyTotal GFE Charges Submitted

                                                                                                                                                                                                                                                                                                                                                  doco Documentation for this format