Extensions for Using Data Elements from FHIR STU3 in FHIR R4B
0.1.0 - STU International flag

Extensions for Using Data Elements from FHIR STU3 in FHIR R4B - Downloaded Version null See the Directory of published versions

Resource Profile: Profile_R3_EligibilityRequest_R4B_CoverageEligibilityRequest

Official URL: http://hl7.org/fhir/3.0/StructureDefinition/profile-EligibilityRequest-for-CoverageEligibilityRequest Version: 0.1.0
Standards status: Trial-use Maturity Level: 0 Computable Name: Profile_R3_EligibilityRequest_R4B_CoverageEligibilityRequest

This cross-version profile allows STU3 EligibilityRequest content to be represented via FHIR R4B CoverageEligibilityRequest resources.

Usages:

  • This Profile is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CoverageEligibilityRequest 0..* CoverageEligibilityRequest(4.3.0) CoverageEligibilityRequest resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:serviced 0..1 Period STU3: Estimated date or dates of Service additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.serviced
Constraints: ext-1
.... extension:benefitCategory 0..1 CodeableConcept STU3: Type of services covered (new)
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.benefitCategory
Binding: R3BenefitCategoryForR4B (0.1.0) (example): Benefit categories such as: oral, medical, vision etc.
Constraints: ext-1
.... extension:benefitSubCategory 0..1 CodeableConcept STU3: Detailed services covered within the type (new)
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.benefitSubCategory
Binding: R3BenefitSubcategoryForR4B (0.1.0) (example): Benefit subcategories such as: oral-basic, major, glasses
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... purpose Σ 1..* code auth-requirements | benefits | discovery | validation
Binding: EligibilityRequestPurpose (required): A code specifying the types of information being requested.
... patient Σ 1..1 Reference(Patient) Intended recipient of products and services
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:patient 0..1 Reference(Resource) STU3: The subject of the Products and Services additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1
... created Σ 1..1 dateTime Creation date
... insurer Σ 1..1 Reference(Organization) Coverage issuer
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:insurer 0..1 Reference(Resource) STU3: Target additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CoverageEligibilityRequest.​status Base required Financial Resource Status Codes 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​purpose Base required EligibilityRequestPurpose 📍4.3.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error CoverageEligibilityRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CoverageEligibilityRequest 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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error CoverageEligibilityRequest 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 CoverageEligibilityRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CoverageEligibilityRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error CoverageEligibilityRequest.implicitRules, CoverageEligibilityRequest.extension, CoverageEligibilityRequest.extension:serviced, CoverageEligibilityRequest.extension:benefitCategory, CoverageEligibilityRequest.extension:benefitSubCategory, CoverageEligibilityRequest.modifierExtension, CoverageEligibilityRequest.status, CoverageEligibilityRequest.purpose, CoverageEligibilityRequest.patient, CoverageEligibilityRequest.patient.extension, CoverageEligibilityRequest.patient.extension:patient, CoverageEligibilityRequest.created, CoverageEligibilityRequest.insurer, CoverageEligibilityRequest.insurer.extension, CoverageEligibilityRequest.insurer.extension:insurer All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error CoverageEligibilityRequest.extension, CoverageEligibilityRequest.extension:serviced, CoverageEligibilityRequest.extension:benefitCategory, CoverageEligibilityRequest.extension:benefitSubCategory, CoverageEligibilityRequest.modifierExtension, CoverageEligibilityRequest.patient.extension, CoverageEligibilityRequest.patient.extension:patient, CoverageEligibilityRequest.insurer.extension, CoverageEligibilityRequest.insurer.extension:insurer Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from CoverageEligibilityRequest

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CoverageEligibilityRequest 0..* CoverageEligibilityRequest(4.3.0) CoverageEligibilityRequest resource
... meta
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:meta 0..1 (Complex) STU3: meta additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.meta
... text
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:text 0..1 (Complex) STU3: text additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.text
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:serviced 0..1 Period STU3: Estimated date or dates of Service additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.serviced
.... extension:benefitCategory 0..1 CodeableConcept STU3: Type of services covered (new)
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.benefitCategory
Binding: R3BenefitCategoryForR4B (0.1.0) (example): Benefit categories such as: oral, medical, vision etc.
.... extension:benefitSubCategory 0..1 CodeableConcept STU3: Detailed services covered within the type (new)
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.benefitSubCategory
Binding: R3BenefitSubcategoryForR4B (0.1.0) (example): Benefit subcategories such as: oral-basic, major, glasses
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:identifier 0..* Identifier STU3: Business Identifier additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.identifier
... patient
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:patient 0..1 Reference(Resource) STU3: The subject of the Products and Services additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... enterer
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:enterer 0..1 Reference(Resource) STU3: enterer additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... provider
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:provider 0..1 Reference(Resource) STU3: Responsible practitioner additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
..... extension:organization 0..1 Reference(Resource) STU3: Responsible organization additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... insurer
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:insurer 0..1 Reference(Resource) STU3: Target additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... facility
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:facility 0..1 Reference(Resource) STU3: Servicing Facility additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CoverageEligibilityRequest 0..* CoverageEligibilityRequest(4.3.0) CoverageEligibilityRequest resource
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:meta 0..1 (Complex) STU3: meta additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.meta
Constraints: ext-1
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible)
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example)
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... 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
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:text 0..1 (Complex) STU3: text additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.text
Constraints: ext-1
.... status 1..1 code generated | extensions | additional | empty
Binding: NarrativeStatus (required)
.... div C 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
... contained 0..* Resource Contained, inline Resources
Constraints: dom-r4b
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:serviced 0..1 Period STU3: Estimated date or dates of Service additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.serviced
Constraints: ext-1
.... extension:benefitCategory 0..1 CodeableConcept STU3: Type of services covered (new)
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.benefitCategory
Binding: R3BenefitCategoryForR4B (0.1.0) (example): Benefit categories such as: oral, medical, vision etc.
Constraints: ext-1
.... extension:benefitSubCategory 0..1 CodeableConcept STU3: Detailed services covered within the type (new)
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.benefitSubCategory
Binding: R3BenefitSubcategoryForR4B (0.1.0) (example): Benefit subcategories such as: oral-basic, major, glasses
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... identifier 0..* Identifier Business Identifier for coverage eligiblity request
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:identifier 0..* Identifier STU3: Business Identifier additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.identifier
Constraints: ext-1
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible)
.... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 0..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
... priority 0..1 CodeableConcept Desired processing priority
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: STAT, normal, Deferred.
... purpose Σ 1..* code auth-requirements | benefits | discovery | validation
Binding: EligibilityRequestPurpose (required): A code specifying the types of information being requested.
... patient Σ 1..1 Reference(Patient) Intended recipient of products and services
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:patient 0..1 Reference(Resource) STU3: The subject of the Products and Services additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... serviced[x] 0..1 Estimated date or dates of service
.... servicedDate date
.... servicedPeriod Period
... created Σ 1..1 dateTime Creation date
... enterer 0..1 Reference(Practitioner | PractitionerRole) Author
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:enterer 0..1 Reference(Resource) STU3: enterer additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... provider 0..1 Reference(Practitioner | PractitionerRole | Organization) Party responsible for the request
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:provider 0..1 Reference(Resource) STU3: Responsible practitioner additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1
..... extension:organization 0..1 Reference(Resource) STU3: Responsible organization additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... insurer Σ 1..1 Reference(Organization) Coverage issuer
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:insurer 0..1 Reference(Resource) STU3: Target additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... facility 0..1 Reference(Location) Servicing facility
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:facility 0..1 Reference(Resource) STU3: Servicing Facility additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... supportingInfo 0..* BackboneElement Supporting information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Information instance identifier
.... information 1..1 Reference(Resource) Data to be provided
.... appliesToAll 0..1 boolean Applies to all items
... insurance 0..* BackboneElement Patient insurance information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... focal 0..1 boolean Applicable coverage
.... coverage 1..1 Reference(Coverage) Insurance information
.... businessArrangement 0..1 string Additional provider contract number
... item 0..* BackboneElement Item to be evaluated for eligibiity
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... supportingInfoSequence 0..* positiveInt Applicable exception or supporting information
.... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision etc.
.... productOrService 0..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.
.... provider 0..1 Reference(Practitioner | PractitionerRole) Perfoming practitioner
.... quantity 0..1 SimpleQuantity(4.3.0) Count of products or services
.... unitPrice 0..1 Money Fee, charge or cost per item
.... facility 0..1 Reference(Location | Organization) Servicing facility
.... diagnosis 0..* BackboneElement Applicable diagnosis
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
..... diagnosis[x] 0..1 Nature of illness or problem
Binding: ICD-10Codes (example): ICD10 Diagnostic codes.
...... diagnosisCodeableConcept CodeableConcept
...... diagnosisReference Reference(Condition)
.... detail 0..* Reference(Resource) Product or service details

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CoverageEligibilityRequest.​meta.security Base extensible SecurityLabels 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​meta.tag Base example Common Tags 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​language Base preferred Common Languages 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​text.status Base required NarrativeStatus 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​identifier.use Base required IdentifierUse 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​identifier.type Base extensible IdentifierType 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​status Base required Financial Resource Status Codes 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​priority Base example Process Priority Codes 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​purpose Base required EligibilityRequestPurpose 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​patient.type Base extensible ResourceType 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​enterer.type Base extensible ResourceType 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​provider.type Base extensible ResourceType 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​insurer.type Base extensible ResourceType 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​facility.type Base extensible ResourceType 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​item.category Base example Benefit Category Codes 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​item.productOrService Base example USCLS Codes 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​item.modifier Base example Modifier type Codes 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​item.diagnosis.diagnosis[x] Base example ICD-10 Codes 📍4.3.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error CoverageEligibilityRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CoverageEligibilityRequest 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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error CoverageEligibilityRequest 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 CoverageEligibilityRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CoverageEligibilityRequest A resource should have narrative for robust management text.`div`.exists()
dom-r4b warning CoverageEligibilityRequest.contained Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
ele-1 error CoverageEligibilityRequest.meta, CoverageEligibilityRequest.meta.extension, CoverageEligibilityRequest.meta.extension:meta, CoverageEligibilityRequest.meta.versionId, CoverageEligibilityRequest.meta.lastUpdated, CoverageEligibilityRequest.meta.source, CoverageEligibilityRequest.meta.profile, CoverageEligibilityRequest.meta.security, CoverageEligibilityRequest.meta.tag, CoverageEligibilityRequest.implicitRules, CoverageEligibilityRequest.language, CoverageEligibilityRequest.text, CoverageEligibilityRequest.text.extension, CoverageEligibilityRequest.text.extension:text, CoverageEligibilityRequest.text.status, CoverageEligibilityRequest.text.div, CoverageEligibilityRequest.extension, CoverageEligibilityRequest.extension:serviced, CoverageEligibilityRequest.extension:benefitCategory, CoverageEligibilityRequest.extension:benefitSubCategory, CoverageEligibilityRequest.modifierExtension, CoverageEligibilityRequest.identifier, CoverageEligibilityRequest.identifier.extension, CoverageEligibilityRequest.identifier.extension:identifier, CoverageEligibilityRequest.identifier.use, CoverageEligibilityRequest.identifier.type, CoverageEligibilityRequest.identifier.system, CoverageEligibilityRequest.identifier.value, CoverageEligibilityRequest.identifier.period, CoverageEligibilityRequest.identifier.assigner, CoverageEligibilityRequest.status, CoverageEligibilityRequest.priority, CoverageEligibilityRequest.purpose, CoverageEligibilityRequest.patient, CoverageEligibilityRequest.patient.extension, CoverageEligibilityRequest.patient.extension:patient, CoverageEligibilityRequest.patient.reference, CoverageEligibilityRequest.patient.type, CoverageEligibilityRequest.patient.identifier, CoverageEligibilityRequest.patient.display, CoverageEligibilityRequest.serviced[x], CoverageEligibilityRequest.created, CoverageEligibilityRequest.enterer, CoverageEligibilityRequest.enterer.extension, CoverageEligibilityRequest.enterer.extension:enterer, CoverageEligibilityRequest.enterer.reference, CoverageEligibilityRequest.enterer.type, CoverageEligibilityRequest.enterer.identifier, CoverageEligibilityRequest.enterer.display, CoverageEligibilityRequest.provider, CoverageEligibilityRequest.provider.extension, CoverageEligibilityRequest.provider.extension:provider, CoverageEligibilityRequest.provider.extension:organization, CoverageEligibilityRequest.provider.reference, CoverageEligibilityRequest.provider.type, CoverageEligibilityRequest.provider.identifier, CoverageEligibilityRequest.provider.display, CoverageEligibilityRequest.insurer, CoverageEligibilityRequest.insurer.extension, CoverageEligibilityRequest.insurer.extension:insurer, CoverageEligibilityRequest.insurer.reference, CoverageEligibilityRequest.insurer.type, CoverageEligibilityRequest.insurer.identifier, CoverageEligibilityRequest.insurer.display, CoverageEligibilityRequest.facility, CoverageEligibilityRequest.facility.extension, CoverageEligibilityRequest.facility.extension:facility, CoverageEligibilityRequest.facility.reference, CoverageEligibilityRequest.facility.type, CoverageEligibilityRequest.facility.identifier, CoverageEligibilityRequest.facility.display, CoverageEligibilityRequest.supportingInfo, CoverageEligibilityRequest.supportingInfo.extension, CoverageEligibilityRequest.supportingInfo.modifierExtension, CoverageEligibilityRequest.supportingInfo.sequence, CoverageEligibilityRequest.supportingInfo.information, CoverageEligibilityRequest.supportingInfo.appliesToAll, CoverageEligibilityRequest.insurance, CoverageEligibilityRequest.insurance.extension, CoverageEligibilityRequest.insurance.modifierExtension, CoverageEligibilityRequest.insurance.focal, CoverageEligibilityRequest.insurance.coverage, CoverageEligibilityRequest.insurance.businessArrangement, CoverageEligibilityRequest.item, CoverageEligibilityRequest.item.extension, CoverageEligibilityRequest.item.modifierExtension, CoverageEligibilityRequest.item.supportingInfoSequence, CoverageEligibilityRequest.item.category, CoverageEligibilityRequest.item.productOrService, CoverageEligibilityRequest.item.modifier, CoverageEligibilityRequest.item.provider, CoverageEligibilityRequest.item.quantity, CoverageEligibilityRequest.item.unitPrice, CoverageEligibilityRequest.item.facility, CoverageEligibilityRequest.item.diagnosis, CoverageEligibilityRequest.item.diagnosis.extension, CoverageEligibilityRequest.item.diagnosis.modifierExtension, CoverageEligibilityRequest.item.diagnosis.diagnosis[x], CoverageEligibilityRequest.item.detail All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error CoverageEligibilityRequest.meta.extension, CoverageEligibilityRequest.meta.extension:meta, CoverageEligibilityRequest.text.extension, CoverageEligibilityRequest.text.extension:text, CoverageEligibilityRequest.extension, CoverageEligibilityRequest.extension:serviced, CoverageEligibilityRequest.extension:benefitCategory, CoverageEligibilityRequest.extension:benefitSubCategory, CoverageEligibilityRequest.modifierExtension, CoverageEligibilityRequest.identifier.extension, CoverageEligibilityRequest.identifier.extension:identifier, CoverageEligibilityRequest.patient.extension, CoverageEligibilityRequest.patient.extension:patient, CoverageEligibilityRequest.enterer.extension, CoverageEligibilityRequest.enterer.extension:enterer, CoverageEligibilityRequest.provider.extension, CoverageEligibilityRequest.provider.extension:provider, CoverageEligibilityRequest.provider.extension:organization, CoverageEligibilityRequest.insurer.extension, CoverageEligibilityRequest.insurer.extension:insurer, CoverageEligibilityRequest.facility.extension, CoverageEligibilityRequest.facility.extension:facility, CoverageEligibilityRequest.supportingInfo.extension, CoverageEligibilityRequest.supportingInfo.modifierExtension, CoverageEligibilityRequest.insurance.extension, CoverageEligibilityRequest.insurance.modifierExtension, CoverageEligibilityRequest.item.extension, CoverageEligibilityRequest.item.modifierExtension, CoverageEligibilityRequest.item.diagnosis.extension, CoverageEligibilityRequest.item.diagnosis.modifierExtension Must have either extensions or value[x], not both extension.exists() != value.exists()
txt-1 error CoverageEligibilityRequest.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlChecks()
txt-2 error CoverageEligibilityRequest.text.div The narrative SHALL have some non-whitespace content htmlChecks()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CoverageEligibilityRequest 0..* CoverageEligibilityRequest(4.3.0) CoverageEligibilityRequest resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:serviced 0..1 Period STU3: Estimated date or dates of Service additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.serviced
Constraints: ext-1
.... extension:benefitCategory 0..1 CodeableConcept STU3: Type of services covered (new)
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.benefitCategory
Binding: R3BenefitCategoryForR4B (0.1.0) (example): Benefit categories such as: oral, medical, vision etc.
Constraints: ext-1
.... extension:benefitSubCategory 0..1 CodeableConcept STU3: Detailed services covered within the type (new)
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.benefitSubCategory
Binding: R3BenefitSubcategoryForR4B (0.1.0) (example): Benefit subcategories such as: oral-basic, major, glasses
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... purpose Σ 1..* code auth-requirements | benefits | discovery | validation
Binding: EligibilityRequestPurpose (required): A code specifying the types of information being requested.
... patient Σ 1..1 Reference(Patient) Intended recipient of products and services
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:patient 0..1 Reference(Resource) STU3: The subject of the Products and Services additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1
... created Σ 1..1 dateTime Creation date
... insurer Σ 1..1 Reference(Organization) Coverage issuer
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:insurer 0..1 Reference(Resource) STU3: Target additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CoverageEligibilityRequest.​status Base required Financial Resource Status Codes 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​purpose Base required EligibilityRequestPurpose 📍4.3.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error CoverageEligibilityRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CoverageEligibilityRequest 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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error CoverageEligibilityRequest 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 CoverageEligibilityRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CoverageEligibilityRequest A resource should have narrative for robust management text.`div`.exists()
ele-1 error CoverageEligibilityRequest.implicitRules, CoverageEligibilityRequest.extension, CoverageEligibilityRequest.extension:serviced, CoverageEligibilityRequest.extension:benefitCategory, CoverageEligibilityRequest.extension:benefitSubCategory, CoverageEligibilityRequest.modifierExtension, CoverageEligibilityRequest.status, CoverageEligibilityRequest.purpose, CoverageEligibilityRequest.patient, CoverageEligibilityRequest.patient.extension, CoverageEligibilityRequest.patient.extension:patient, CoverageEligibilityRequest.created, CoverageEligibilityRequest.insurer, CoverageEligibilityRequest.insurer.extension, CoverageEligibilityRequest.insurer.extension:insurer All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error CoverageEligibilityRequest.extension, CoverageEligibilityRequest.extension:serviced, CoverageEligibilityRequest.extension:benefitCategory, CoverageEligibilityRequest.extension:benefitSubCategory, CoverageEligibilityRequest.modifierExtension, CoverageEligibilityRequest.patient.extension, CoverageEligibilityRequest.patient.extension:patient, CoverageEligibilityRequest.insurer.extension, CoverageEligibilityRequest.insurer.extension:insurer Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

This structure is derived from CoverageEligibilityRequest

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CoverageEligibilityRequest 0..* CoverageEligibilityRequest(4.3.0) CoverageEligibilityRequest resource
... meta
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:meta 0..1 (Complex) STU3: meta additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.meta
... text
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:text 0..1 (Complex) STU3: text additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.text
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:serviced 0..1 Period STU3: Estimated date or dates of Service additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.serviced
.... extension:benefitCategory 0..1 CodeableConcept STU3: Type of services covered (new)
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.benefitCategory
Binding: R3BenefitCategoryForR4B (0.1.0) (example): Benefit categories such as: oral, medical, vision etc.
.... extension:benefitSubCategory 0..1 CodeableConcept STU3: Detailed services covered within the type (new)
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.benefitSubCategory
Binding: R3BenefitSubcategoryForR4B (0.1.0) (example): Benefit subcategories such as: oral-basic, major, glasses
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:identifier 0..* Identifier STU3: Business Identifier additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.identifier
... patient
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:patient 0..1 Reference(Resource) STU3: The subject of the Products and Services additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... enterer
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:enterer 0..1 Reference(Resource) STU3: enterer additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... provider
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:provider 0..1 Reference(Resource) STU3: Responsible practitioner additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
..... extension:organization 0..1 Reference(Resource) STU3: Responsible organization additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... insurer
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:insurer 0..1 Reference(Resource) STU3: Target additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... facility
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:facility 0..1 Reference(Resource) STU3: Servicing Facility additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CoverageEligibilityRequest 0..* CoverageEligibilityRequest(4.3.0) CoverageEligibilityRequest resource
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:meta 0..1 (Complex) STU3: meta additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.meta
Constraints: ext-1
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible)
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example)
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... 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
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:text 0..1 (Complex) STU3: text additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.text
Constraints: ext-1
.... status 1..1 code generated | extensions | additional | empty
Binding: NarrativeStatus (required)
.... div C 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
... contained 0..* Resource Contained, inline Resources
Constraints: dom-r4b
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:serviced 0..1 Period STU3: Estimated date or dates of Service additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.serviced
Constraints: ext-1
.... extension:benefitCategory 0..1 CodeableConcept STU3: Type of services covered (new)
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.benefitCategory
Binding: R3BenefitCategoryForR4B (0.1.0) (example): Benefit categories such as: oral, medical, vision etc.
Constraints: ext-1
.... extension:benefitSubCategory 0..1 CodeableConcept STU3: Detailed services covered within the type (new)
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.benefitSubCategory
Binding: R3BenefitSubcategoryForR4B (0.1.0) (example): Benefit subcategories such as: oral-basic, major, glasses
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... identifier 0..* Identifier Business Identifier for coverage eligiblity request
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:identifier 0..* Identifier STU3: Business Identifier additional types
URL: http://hl7.org/fhir/3.0/StructureDefinition/extension-EligibilityRequest.identifier
Constraints: ext-1
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible)
.... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 0..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
... priority 0..1 CodeableConcept Desired processing priority
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: STAT, normal, Deferred.
... purpose Σ 1..* code auth-requirements | benefits | discovery | validation
Binding: EligibilityRequestPurpose (required): A code specifying the types of information being requested.
... patient Σ 1..1 Reference(Patient) Intended recipient of products and services
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:patient 0..1 Reference(Resource) STU3: The subject of the Products and Services additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... serviced[x] 0..1 Estimated date or dates of service
.... servicedDate date
.... servicedPeriod Period
... created Σ 1..1 dateTime Creation date
... enterer 0..1 Reference(Practitioner | PractitionerRole) Author
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:enterer 0..1 Reference(Resource) STU3: enterer additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... provider 0..1 Reference(Practitioner | PractitionerRole | Organization) Party responsible for the request
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:provider 0..1 Reference(Resource) STU3: Responsible practitioner additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1
..... extension:organization 0..1 Reference(Resource) STU3: Responsible organization additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... insurer Σ 1..1 Reference(Organization) Coverage issuer
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:insurer 0..1 Reference(Resource) STU3: Target additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... facility 0..1 Reference(Location) Servicing facility
.... id 0..1 id Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:facility 0..1 Reference(Resource) STU3: Servicing Facility additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
Constraints: ext-1
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible)
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... supportingInfo 0..* BackboneElement Supporting information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Information instance identifier
.... information 1..1 Reference(Resource) Data to be provided
.... appliesToAll 0..1 boolean Applies to all items
... insurance 0..* BackboneElement Patient insurance information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... focal 0..1 boolean Applicable coverage
.... coverage 1..1 Reference(Coverage) Insurance information
.... businessArrangement 0..1 string Additional provider contract number
... item 0..* BackboneElement Item to be evaluated for eligibiity
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... supportingInfoSequence 0..* positiveInt Applicable exception or supporting information
.... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision etc.
.... productOrService 0..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.
.... provider 0..1 Reference(Practitioner | PractitionerRole) Perfoming practitioner
.... quantity 0..1 SimpleQuantity(4.3.0) Count of products or services
.... unitPrice 0..1 Money Fee, charge or cost per item
.... facility 0..1 Reference(Location | Organization) Servicing facility
.... diagnosis 0..* BackboneElement Applicable diagnosis
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
..... diagnosis[x] 0..1 Nature of illness or problem
Binding: ICD-10Codes (example): ICD10 Diagnostic codes.
...... diagnosisCodeableConcept CodeableConcept
...... diagnosisReference Reference(Condition)
.... detail 0..* Reference(Resource) Product or service details

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CoverageEligibilityRequest.​meta.security Base extensible SecurityLabels 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​meta.tag Base example Common Tags 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​language Base preferred Common Languages 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​text.status Base required NarrativeStatus 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​identifier.use Base required IdentifierUse 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​identifier.type Base extensible IdentifierType 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​status Base required Financial Resource Status Codes 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​priority Base example Process Priority Codes 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​purpose Base required EligibilityRequestPurpose 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​patient.type Base extensible ResourceType 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​enterer.type Base extensible ResourceType 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​provider.type Base extensible ResourceType 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​insurer.type Base extensible ResourceType 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​facility.type Base extensible ResourceType 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​item.category Base example Benefit Category Codes 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​item.productOrService Base example USCLS Codes 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​item.modifier Base example Modifier type Codes 📍4.3.0 FHIR Std.
CoverageEligibilityRequest.​item.diagnosis.diagnosis[x] Base example ICD-10 Codes 📍4.3.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error CoverageEligibilityRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CoverageEligibilityRequest 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.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error CoverageEligibilityRequest 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 CoverageEligibilityRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CoverageEligibilityRequest A resource should have narrative for robust management text.`div`.exists()
dom-r4b warning CoverageEligibilityRequest.contained Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
ele-1 error CoverageEligibilityRequest.meta, CoverageEligibilityRequest.meta.extension, CoverageEligibilityRequest.meta.extension:meta, CoverageEligibilityRequest.meta.versionId, CoverageEligibilityRequest.meta.lastUpdated, CoverageEligibilityRequest.meta.source, CoverageEligibilityRequest.meta.profile, CoverageEligibilityRequest.meta.security, CoverageEligibilityRequest.meta.tag, CoverageEligibilityRequest.implicitRules, CoverageEligibilityRequest.language, CoverageEligibilityRequest.text, CoverageEligibilityRequest.text.extension, CoverageEligibilityRequest.text.extension:text, CoverageEligibilityRequest.text.status, CoverageEligibilityRequest.text.div, CoverageEligibilityRequest.extension, CoverageEligibilityRequest.extension:serviced, CoverageEligibilityRequest.extension:benefitCategory, CoverageEligibilityRequest.extension:benefitSubCategory, CoverageEligibilityRequest.modifierExtension, CoverageEligibilityRequest.identifier, CoverageEligibilityRequest.identifier.extension, CoverageEligibilityRequest.identifier.extension:identifier, CoverageEligibilityRequest.identifier.use, CoverageEligibilityRequest.identifier.type, CoverageEligibilityRequest.identifier.system, CoverageEligibilityRequest.identifier.value, CoverageEligibilityRequest.identifier.period, CoverageEligibilityRequest.identifier.assigner, CoverageEligibilityRequest.status, CoverageEligibilityRequest.priority, CoverageEligibilityRequest.purpose, CoverageEligibilityRequest.patient, CoverageEligibilityRequest.patient.extension, CoverageEligibilityRequest.patient.extension:patient, CoverageEligibilityRequest.patient.reference, CoverageEligibilityRequest.patient.type, CoverageEligibilityRequest.patient.identifier, CoverageEligibilityRequest.patient.display, CoverageEligibilityRequest.serviced[x], CoverageEligibilityRequest.created, CoverageEligibilityRequest.enterer, CoverageEligibilityRequest.enterer.extension, CoverageEligibilityRequest.enterer.extension:enterer, CoverageEligibilityRequest.enterer.reference, CoverageEligibilityRequest.enterer.type, CoverageEligibilityRequest.enterer.identifier, CoverageEligibilityRequest.enterer.display, CoverageEligibilityRequest.provider, CoverageEligibilityRequest.provider.extension, CoverageEligibilityRequest.provider.extension:provider, CoverageEligibilityRequest.provider.extension:organization, CoverageEligibilityRequest.provider.reference, CoverageEligibilityRequest.provider.type, CoverageEligibilityRequest.provider.identifier, CoverageEligibilityRequest.provider.display, CoverageEligibilityRequest.insurer, CoverageEligibilityRequest.insurer.extension, CoverageEligibilityRequest.insurer.extension:insurer, CoverageEligibilityRequest.insurer.reference, CoverageEligibilityRequest.insurer.type, CoverageEligibilityRequest.insurer.identifier, CoverageEligibilityRequest.insurer.display, CoverageEligibilityRequest.facility, CoverageEligibilityRequest.facility.extension, CoverageEligibilityRequest.facility.extension:facility, CoverageEligibilityRequest.facility.reference, CoverageEligibilityRequest.facility.type, CoverageEligibilityRequest.facility.identifier, CoverageEligibilityRequest.facility.display, CoverageEligibilityRequest.supportingInfo, CoverageEligibilityRequest.supportingInfo.extension, CoverageEligibilityRequest.supportingInfo.modifierExtension, CoverageEligibilityRequest.supportingInfo.sequence, CoverageEligibilityRequest.supportingInfo.information, CoverageEligibilityRequest.supportingInfo.appliesToAll, CoverageEligibilityRequest.insurance, CoverageEligibilityRequest.insurance.extension, CoverageEligibilityRequest.insurance.modifierExtension, CoverageEligibilityRequest.insurance.focal, CoverageEligibilityRequest.insurance.coverage, CoverageEligibilityRequest.insurance.businessArrangement, CoverageEligibilityRequest.item, CoverageEligibilityRequest.item.extension, CoverageEligibilityRequest.item.modifierExtension, CoverageEligibilityRequest.item.supportingInfoSequence, CoverageEligibilityRequest.item.category, CoverageEligibilityRequest.item.productOrService, CoverageEligibilityRequest.item.modifier, CoverageEligibilityRequest.item.provider, CoverageEligibilityRequest.item.quantity, CoverageEligibilityRequest.item.unitPrice, CoverageEligibilityRequest.item.facility, CoverageEligibilityRequest.item.diagnosis, CoverageEligibilityRequest.item.diagnosis.extension, CoverageEligibilityRequest.item.diagnosis.modifierExtension, CoverageEligibilityRequest.item.diagnosis.diagnosis[x], CoverageEligibilityRequest.item.detail All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error CoverageEligibilityRequest.meta.extension, CoverageEligibilityRequest.meta.extension:meta, CoverageEligibilityRequest.text.extension, CoverageEligibilityRequest.text.extension:text, CoverageEligibilityRequest.extension, CoverageEligibilityRequest.extension:serviced, CoverageEligibilityRequest.extension:benefitCategory, CoverageEligibilityRequest.extension:benefitSubCategory, CoverageEligibilityRequest.modifierExtension, CoverageEligibilityRequest.identifier.extension, CoverageEligibilityRequest.identifier.extension:identifier, CoverageEligibilityRequest.patient.extension, CoverageEligibilityRequest.patient.extension:patient, CoverageEligibilityRequest.enterer.extension, CoverageEligibilityRequest.enterer.extension:enterer, CoverageEligibilityRequest.provider.extension, CoverageEligibilityRequest.provider.extension:provider, CoverageEligibilityRequest.provider.extension:organization, CoverageEligibilityRequest.insurer.extension, CoverageEligibilityRequest.insurer.extension:insurer, CoverageEligibilityRequest.facility.extension, CoverageEligibilityRequest.facility.extension:facility, CoverageEligibilityRequest.supportingInfo.extension, CoverageEligibilityRequest.supportingInfo.modifierExtension, CoverageEligibilityRequest.insurance.extension, CoverageEligibilityRequest.insurance.modifierExtension, CoverageEligibilityRequest.item.extension, CoverageEligibilityRequest.item.modifierExtension, CoverageEligibilityRequest.item.diagnosis.extension, CoverageEligibilityRequest.item.diagnosis.modifierExtension Must have either extensions or value[x], not both extension.exists() != value.exists()
txt-1 error CoverageEligibilityRequest.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlChecks()
txt-2 error CoverageEligibilityRequest.text.div The narrative SHALL have some non-whitespace content htmlChecks()

 

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