Left: | QICoreClaim (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim) |
Right: | QICoreClaim (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim) |
Error | StructureDefinition.version | Values for version differ: '4.1.0' vs '4.1.1' |
Error | Claim.patient | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient]]) |
Error | Claim.provider | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitionerrole], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitionerrole], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization]]) |
Error | Claim.prescription | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicerequest], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest], CanonicalType[http://hl7.org/fhir/StructureDefinition/VisionPrescription]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicerequest], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest], CanonicalType[http://hl7.org/fhir/StructureDefinition/VisionPrescription]]) |
Error | Claim.payee.party | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitionerrole], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitionerrole], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson]]) |
Error | Claim.referral | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest]]) |
Error | Claim.facility | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location]]) |
Error | Claim.careTeam.provider | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitionerrole], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitionerrole], CanonicalType[http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization]]) |
Name | Value | Comments | |
---|---|---|---|
abstract | false | ||
baseDefinition | http://hl7.org/fhir/StructureDefinition/Claim | ||
copyright | |||
date | 2018-08-22 | ||
description | Profile of Claim for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors. | ||
experimental | false | ||
fhirVersion | 4.0.1 | ||
jurisdiction | |||
jurisdiction[0] | urn:iso:std:iso:3166#US | ||
kind | resource | ||
name | QICoreClaim | ||
publisher | http://www.hl7.org/Special/committees/cqi/index.cfm | ||
purpose | |||
status | draft | ||
title | |||
type | Claim | ||
url | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim | ||
version | 4.1.0 | 4.1.1 |
|
Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | L Type | L Description & Constraints | Comments |
---|---|---|---|---|---|---|---|---|---|
Claim | 0..* | Claim | Claim, Pre-determination or Pre-authorization | 0..* | Claim | Claim, Pre-determination or Pre-authorization | |||
id | Σ | 0..1 | string | Logical id of this artifact | Σ | 0..1 | string | Logical id of this artifact | |
meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource | |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created | |
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||
contained | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |
identifier | 0..* | Identifier | Business Identifier for claim | 0..* | Identifier | Business Identifier for claim | |||
status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | |
type | Σ | 1..1 | CodeableConcept | Category or discipline Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim. | Σ | 1..1 | CodeableConcept | Category or discipline Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim. | |
subType | 0..1 | CodeableConcept | More granular claim type Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode. | 0..1 | CodeableConcept | More granular claim type Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode. | |||
use | Σ | 1..1 | code | claim | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim. | Σ | 1..1 | code | claim | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim. | |
patient | SΣ | 1..1 | Reference(QICorePatient) | The recipient of the products and services | SΣ | 1..1 | Reference(QICorePatient) | The recipient of the products and services |
|
billablePeriod | SΣ | 0..1 | Period | Relevant time frame for the claim | SΣ | 0..1 | Period | Relevant time frame for the claim | |
created | SΣ | 1..1 | dateTime | Resource creation date | SΣ | 1..1 | dateTime | Resource creation date | |
enterer | 0..1 | Reference(Practitioner | PractitionerRole) | Author of the claim | 0..1 | Reference(Practitioner | PractitionerRole) | Author of the claim | |||
insurer | Σ | 0..1 | Reference(Organization) | Target | Σ | 0..1 | Reference(Organization) | Target | |
provider | SΣ | 1..1 | Reference(QICorePractitioner | QICorePractitionerRole | QICoreOrganization) | Party responsible for the claim | SΣ | 1..1 | Reference(QICorePractitioner | QICorePractitionerRole | QICoreOrganization) | Party responsible for the claim |
|
priority | Σ | 1..1 | CodeableConcept | Desired processing ugency Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred. | Σ | 1..1 | CodeableConcept | Desired processing ugency Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred. | |
fundsReserve | 0..1 | CodeableConcept | For whom to reserve funds Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None). | 0..1 | CodeableConcept | For whom to reserve funds Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None). | |||
related | 0..* | BackboneElement | Prior or corollary claims | 0..* | BackboneElement | Prior or corollary claims | |||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
claim | 0..1 | Reference(Claim) | Reference to the related claim | 0..1 | Reference(Claim) | Reference to the related claim | |||
relationship | 0..1 | CodeableConcept | How the reference claim is related Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim. | 0..1 | CodeableConcept | How the reference claim is related Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim. | |||
reference | 0..1 | Identifier | File or case reference | 0..1 | Identifier | File or case reference | |||
prescription | S | 0..1 | Reference(QICoreDeviceRequest | QICoreMedicationRequest | VisionPrescription) | Prescription authorizing services and products | S | 0..1 | Reference(QICoreDeviceRequest | QICoreMedicationRequest | VisionPrescription) | Prescription authorizing services and products |
|
originalPrescription | 0..1 | Reference(DeviceRequest | MedicationRequest | VisionPrescription) | Original prescription if superseded by fulfiller | 0..1 | Reference(DeviceRequest | MedicationRequest | VisionPrescription) | Original prescription if superseded by fulfiller | |||
payee | 0..1 | BackboneElement | Recipient of benefits payable | 0..1 | BackboneElement | Recipient of benefits payable | |||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
type | 1..1 | CodeableConcept | Category of recipient Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed. | 1..1 | CodeableConcept | Category of recipient Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed. | |||
party | 0..1 | Reference(QICorePractitioner | QICorePractitionerRole | QICoreOrganization | QICorePatient | QICoreRelatedPerson) | Recipient reference | 0..1 | Reference(QICorePractitioner | QICorePractitionerRole | QICoreOrganization | QICorePatient | QICoreRelatedPerson) | Recipient reference |
| ||
referral | 0..1 | Reference(QICoreServiceRequest) | Treatment referral | 0..1 | Reference(QICoreServiceRequest) | Treatment referral |
| ||
facility | 0..1 | Reference(QICoreLocation) | Servicing facility | 0..1 | Reference(QICoreLocation) | Servicing facility |
| ||
careTeam | 0..* | BackboneElement | Members of the care team | 0..* | BackboneElement | Members of the care team | |||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
sequence | 1..1 | positiveInt | Order of care team | 1..1 | positiveInt | Order of care team | |||
provider | 1..1 | Reference(QICorePractitioner | QICorePractitionerRole | QICoreOrganization) | Practitioner or organization | 1..1 | Reference(QICorePractitioner | QICorePractitionerRole | QICoreOrganization) | Practitioner or organization |
| ||
responsible | 0..1 | boolean | Indicator of the lead practitioner | 0..1 | boolean | Indicator of the lead practitioner | |||
role | 0..1 | CodeableConcept | Function within the team Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members. | 0..1 | CodeableConcept | Function within the team Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members. | |||
qualification | 0..1 | CodeableConcept | Practitioner credential or specialization Binding: ExampleProviderQualificationCodes (example): Provider professional qualifications. | 0..1 | CodeableConcept | Practitioner credential or specialization Binding: ExampleProviderQualificationCodes (example): Provider professional qualifications. | |||
supportingInfo | 0..* | BackboneElement | Supporting information | 0..* | BackboneElement | Supporting information | |||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
sequence | 1..1 | positiveInt | Information instance identifier | 1..1 | positiveInt | Information instance identifier | |||
category | 1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. | 1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. | |||
code | 0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | 0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||
timing[x] | 0..1 | date, Period | When it occurred | 0..1 | date, Period | When it occurred | |||
value[x] | 0..1 | boolean, string, Quantity, Attachment, Reference(Resource) | Data to be provided | 0..1 | boolean, string, Quantity, Attachment, Reference(Resource) | Data to be provided | |||
reason | 0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | 0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||
diagnosis | 0..* | BackboneElement | Pertinent diagnosis information | 0..* | BackboneElement | Pertinent diagnosis information | |||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
sequence | 1..1 | positiveInt | Diagnosis instance identifier | 1..1 | positiveInt | Diagnosis instance identifier | |||
diagnosis[x] | 1..1 | CodeableConcept, Reference(Condition) | Nature of illness or problem Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes. | 1..1 | CodeableConcept, Reference(Condition) | Nature of illness or problem Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes. | |||
type | 0..* | CodeableConcept | Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. | 0..* | CodeableConcept | Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. | |||
onAdmission | 0..1 | CodeableConcept | Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission. | 0..1 | CodeableConcept | Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission. | |||
packageCode | 0..1 | CodeableConcept | Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis. | 0..1 | CodeableConcept | Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis. | |||
procedure | 0..* | BackboneElement | Clinical procedures performed | 0..* | BackboneElement | Clinical procedures performed | |||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
sequence | 1..1 | positiveInt | Procedure instance identifier | 1..1 | positiveInt | Procedure instance identifier | |||
type | 0..* | CodeableConcept | Category of Procedure Binding: ExampleProcedureTypeCodes (example): Example procedure type codes. | 0..* | CodeableConcept | Category of Procedure Binding: ExampleProcedureTypeCodes (example): Example procedure type codes. | |||
date | 0..1 | dateTime | When the procedure was performed | 0..1 | dateTime | When the procedure was performed | |||
procedure[x] | 1..1 | CodeableConcept, Reference(Procedure) | Specific clinical procedure Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes. | 1..1 | CodeableConcept, Reference(Procedure) | Specific clinical procedure Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes. | |||
udi | 0..* | Reference(Device) | Unique device identifier | 0..* | Reference(Device) | Unique device identifier | |||
insurance | Σ | 1..* | BackboneElement | Patient insurance information | Σ | 1..* | BackboneElement | Patient insurance information | |
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
sequence | Σ | 1..1 | positiveInt | Insurance instance identifier | Σ | 1..1 | positiveInt | Insurance instance identifier | |
focal | Σ | 1..1 | boolean | Coverage to be used for adjudication | Σ | 1..1 | boolean | Coverage to be used for adjudication | |
identifier | 0..1 | Identifier | Pre-assigned Claim number | 0..1 | Identifier | Pre-assigned Claim number | |||
coverage | Σ | 1..1 | Reference(Coverage) | Insurance information | Σ | 1..1 | Reference(Coverage) | Insurance information | |
businessArrangement | 0..1 | string | Additional provider contract number | 0..1 | string | Additional provider contract number | |||
preAuthRef | 0..* | string | Prior authorization reference number | 0..* | string | Prior authorization reference number | |||
claimResponse | 0..1 | Reference(ClaimResponse) | Adjudication results | 0..1 | Reference(ClaimResponse) | Adjudication results | |||
accident | 0..1 | BackboneElement | Details of the event | 0..1 | BackboneElement | Details of the event | |||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
date | 1..1 | date | When the incident occurred | 1..1 | date | When the incident occurred | |||
type | 0..1 | CodeableConcept | The nature of the accident Binding: ActIncidentCode (extensible): Type of accident: work place, auto, etc. | 0..1 | CodeableConcept | The nature of the accident Binding: ActIncidentCode (extensible): Type of accident: work place, auto, etc. | |||
location[x] | 0..1 | Address, Reference(Location) | Where the event occurred | 0..1 | Address, Reference(Location) | Where the event occurred | |||
item | 0..* | BackboneElement | Product or service provided | 0..* | BackboneElement | Product or service provided | |||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
sequence | 1..1 | positiveInt | Item instance identifier | 1..1 | positiveInt | Item instance identifier | |||
careTeamSequence | 0..* | positiveInt | Applicable careTeam members | 0..* | positiveInt | Applicable careTeam members | |||
diagnosisSequence | 0..* | positiveInt | Applicable diagnoses | 0..* | positiveInt | Applicable diagnoses | |||
procedureSequence | 0..* | positiveInt | Applicable procedures | 0..* | positiveInt | Applicable procedures | |||
informationSequence | 0..* | positiveInt | Applicable exception and supporting information | 0..* | positiveInt | Applicable exception and supporting information | |||
revenue | 0..1 | CodeableConcept | Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products. | 0..1 | CodeableConcept | Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products. | |||
category | 0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses. | 0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses. | |||
productOrService | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |||
modifier | 0..* | CodeableConcept | Product or service billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | 0..* | CodeableConcept | Product or service billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||
programCode | 0..* | CodeableConcept | Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes. | 0..* | CodeableConcept | Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes. | |||
serviced[x] | 0..1 | date, Period | Date or dates of service or product delivery | 0..1 | date, Period | Date or dates of service or product delivery | |||
location[x] | 0..1 | CodeableConcept, Address, Reference(Location) | Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc. | 0..1 | CodeableConcept, Address, Reference(Location) | Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc. | |||
quantity | 0..1 | SimpleQuantity | Count of products or services | 0..1 | SimpleQuantity | Count of products or services | |||
unitPrice | 0..1 | Money | Fee, charge or cost per item | 0..1 | Money | Fee, charge or cost per item | |||
factor | 0..1 | decimal | Price scaling factor | 0..1 | decimal | Price scaling factor | |||
net | 0..1 | Money | Total item cost | 0..1 | Money | Total item cost | |||
udi | 0..* | Reference(Device) | Unique device identifier | 0..* | Reference(Device) | Unique device identifier | |||
bodySite | 0..1 | CodeableConcept | Anatomical location Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch. | 0..1 | CodeableConcept | Anatomical location Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch. | |||
subSite | 0..* | CodeableConcept | Anatomical sub-location Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations. | 0..* | CodeableConcept | Anatomical sub-location Binding: SurfaceCodes (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 | 0..* | BackboneElement | Product or service provided | 0..* | BackboneElement | Product or service provided | |||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
sequence | 1..1 | positiveInt | Item instance identifier | 1..1 | positiveInt | Item instance identifier | |||
revenue | 0..1 | CodeableConcept | Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products. | 0..1 | CodeableConcept | Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products. | |||
category | 0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses. | 0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses. | |||
productOrService | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |||
modifier | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||
programCode | 0..* | CodeableConcept | Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes. | 0..* | CodeableConcept | Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes. | |||
quantity | 0..1 | SimpleQuantity | Count of products or services | 0..1 | SimpleQuantity | Count of products or services | |||
unitPrice | 0..1 | Money | Fee, charge or cost per item | 0..1 | Money | Fee, charge or cost per item | |||
factor | 0..1 | decimal | Price scaling factor | 0..1 | decimal | Price scaling factor | |||
net | 0..1 | Money | Total item cost | 0..1 | Money | Total item cost | |||
udi | 0..* | Reference(Device) | Unique device identifier | 0..* | Reference(Device) | Unique device identifier | |||
subDetail | 0..* | BackboneElement | Product or service provided | 0..* | BackboneElement | Product or service provided | |||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
sequence | 1..1 | positiveInt | Item instance identifier | 1..1 | positiveInt | Item instance identifier | |||
revenue | 0..1 | CodeableConcept | Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products. | 0..1 | CodeableConcept | Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products. | |||
category | 0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses. | 0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses. | |||
productOrService | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |||
modifier | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||
programCode | 0..* | CodeableConcept | Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes. | 0..* | CodeableConcept | Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes. | |||
quantity | 0..1 | SimpleQuantity | Count of products or services | 0..1 | SimpleQuantity | Count of products or services | |||
unitPrice | 0..1 | Money | Fee, charge or cost per item | 0..1 | Money | Fee, charge or cost per item | |||
factor | 0..1 | decimal | Price scaling factor | 0..1 | decimal | Price scaling factor | |||
net | 0..1 | Money | Total item cost | 0..1 | Money | Total item cost | |||
udi | 0..* | Reference(Device) | Unique device identifier | 0..* | Reference(Device) | Unique device identifier | |||
total | 0..1 | Money | Total claim cost | 0..1 | Money | Total claim cost | |||
Documentation for this format |