Patient Cost Transparency Implementation Guide
2.0.0 - STU 2 United States of America flag

This page is part of the Da Vinci Patient Cost Transparency Implementation Guide (v2.0.0: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: PCT AEOB Adjudication Error

Official URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-aeob-adjudication-error Version: 2.0.0
Standards status: Trial-use Maturity Level: 2 Computable Name: AEOBAdjudicationError
Other Identifiers: OID:2.16.840.1.113883.4.642.40.4.42.2

OperationOutcome returned from the gfeSubmit operation when there are adjudication errors during AEOB processing

Usages:

You can also check for usages in the FHIR IG Statistics

Changes since version 1.1.0:

  • No changes

    • Formal Views of Profile Content

    Description of Profiles, Differentials, Snapshots and how the different presentations work.

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. OperationOutcome 0..* OperationOutcome Information about the success/failure of an action
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... issue Σ 1..* BackboneElement A single issue associated with the action
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... severity Σ 1..1 code fatal | error | warning | information
    Binding: IssueSeverity (required): How the issue affects the success of the action.
    Required Pattern: error
    .... code Σ 1..1 code Error or warning code
    Binding: IssueType (required): A code that describes the type of issue.
    Required Pattern: processing
    .... diagnostics Σ 1..1 string Additional diagnostic information about the issue

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    OperationOutcome.issue.​severity Base required IssueSeverity 📍4.0.1 FHIR Std.
    OperationOutcome.issue.​code Base required IssueType 📍4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error OperationOutcome If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error OperationOutcome If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4 error OperationOutcome If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5 error OperationOutcome If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice OperationOutcome A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

    This structure is derived from OperationOutcome

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. OperationOutcome 0..* OperationOutcome Information about the success/failure of an action
    ... issue
    .... severity 1..1 code fatal | error | warning | information
    Required Pattern: error
    .... code 1..1 code Error or warning code
    Required Pattern: processing
    .... diagnostics 1..1 string Additional diagnostic information about the issue

    doco Documentation for this format
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. OperationOutcome 0..* OperationOutcome Information about the success/failure of an action
    ... id Σ 0..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.
    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    This profile does not constrain the narrative in regard to content, language, or traceability to data elements
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... issue Σ 1..* BackboneElement A single issue associated with the action
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... severity Σ 1..1 code fatal | error | warning | information
    Binding: IssueSeverity (required): How the issue affects the success of the action.
    Required Pattern: error
    .... code Σ 1..1 code Error or warning code
    Binding: IssueType (required): A code that describes the type of issue.
    Required Pattern: processing
    .... details Σ 0..1 CodeableConcept Additional details about the error
    Binding: OperationOutcomeCodes (example): A code that provides details as the exact issue.
    .... diagnostics Σ 1..1 string Additional diagnostic information about the issue
    .... location Σ 0..* string Deprecated: Path of element(s) related to issue
    .... expression Σ 0..* string FHIRPath of element(s) related to issue

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    OperationOutcome.language Base preferred Common Languages 📍4.0.1 FHIR Std.
    OperationOutcome.issue.​severity Base required IssueSeverity 📍4.0.1 FHIR Std.
    OperationOutcome.issue.​code Base required IssueType 📍4.0.1 FHIR Std.
    OperationOutcome.issue.​details Base example Operation Outcome Codes 📍4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error OperationOutcome If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error OperationOutcome If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4 error OperationOutcome If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5 error OperationOutcome If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice OperationOutcome A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

    This structure is derived from OperationOutcome

    Summary

    Mandatory: 1 element

    Maturity: 2

    Key Elements View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. OperationOutcome 0..* OperationOutcome Information about the success/failure of an action
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... issue Σ 1..* BackboneElement A single issue associated with the action
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... severity Σ 1..1 code fatal | error | warning | information
    Binding: IssueSeverity (required): How the issue affects the success of the action.
    Required Pattern: error
    .... code Σ 1..1 code Error or warning code
    Binding: IssueType (required): A code that describes the type of issue.
    Required Pattern: processing
    .... diagnostics Σ 1..1 string Additional diagnostic information about the issue

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    OperationOutcome.issue.​severity Base required IssueSeverity 📍4.0.1 FHIR Std.
    OperationOutcome.issue.​code Base required IssueType 📍4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error OperationOutcome If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error OperationOutcome If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4 error OperationOutcome If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5 error OperationOutcome If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice OperationOutcome A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

    Differential View

    This structure is derived from OperationOutcome

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. OperationOutcome 0..* OperationOutcome Information about the success/failure of an action
    ... issue
    .... severity 1..1 code fatal | error | warning | information
    Required Pattern: error
    .... code 1..1 code Error or warning code
    Required Pattern: processing
    .... diagnostics 1..1 string Additional diagnostic information about the issue

    doco Documentation for this format

    Snapshot View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. OperationOutcome 0..* OperationOutcome Information about the success/failure of an action
    ... id Σ 0..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.
    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    This profile does not constrain the narrative in regard to content, language, or traceability to data elements
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... issue Σ 1..* BackboneElement A single issue associated with the action
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... severity Σ 1..1 code fatal | error | warning | information
    Binding: IssueSeverity (required): How the issue affects the success of the action.
    Required Pattern: error
    .... code Σ 1..1 code Error or warning code
    Binding: IssueType (required): A code that describes the type of issue.
    Required Pattern: processing
    .... details Σ 0..1 CodeableConcept Additional details about the error
    Binding: OperationOutcomeCodes (example): A code that provides details as the exact issue.
    .... diagnostics Σ 1..1 string Additional diagnostic information about the issue
    .... location Σ 0..* string Deprecated: Path of element(s) related to issue
    .... expression Σ 0..* string FHIRPath of element(s) related to issue

    doco Documentation for this format

    Terminology Bindings

    Path Status Usage ValueSet Version Source
    OperationOutcome.language Base preferred Common Languages 📍4.0.1 FHIR Std.
    OperationOutcome.issue.​severity Base required IssueSeverity 📍4.0.1 FHIR Std.
    OperationOutcome.issue.​code Base required IssueType 📍4.0.1 FHIR Std.
    OperationOutcome.issue.​details Base example Operation Outcome Codes 📍4.0.1 FHIR Std.

    Constraints

    Id Grade Path(s) Description Expression
    dom-2 error OperationOutcome If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
    dom-3 error OperationOutcome If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
    dom-4 error OperationOutcome If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
    dom-5 error OperationOutcome If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
    dom-6 best practice OperationOutcome A resource should have narrative for robust management text.`div`.exists()
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

    This structure is derived from OperationOutcome

    Summary

    Mandatory: 1 element

    Maturity: 2

     

    Other representations of profile: CSV, Excel, Schematron