Generated Narrative: StructureDefinition ext-R4-ExplanationOfBenefit.add.det.subDetail Name Flags Card. Type Description & Constraints Extension 0..* Extension R4: Insurer added line items (new) #xD; Slices for extension 1..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:productOrService 1..1 Extension R4: Billing, service, product, or drug code (new) #xD; url 1..1 uri "productOrService" #xD; value[x] 1..1 CodeableConcept Billing, service, product, or drug code Binding: USCLS Codes (example): Allowable service and product codes. #xD; extension:modifier 0..* Extension R4: Service/Product billing modifiers (new) #xD; url 1..1 uri "modifier" #xD; value[x] 0..1 CodeableConcept Service/Product billing modifiers Binding: Modifier type Codes (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. #xD; extension:quantity 0..1 Extension R4: Count of products or services (new) #xD; url 1..1 uri "quantity" #xD; value[x] 0..1 SimpleQuantity Count of products or services #xD; extension:unitPrice 0..1 Extension R4: Fee, charge or cost per item (new) #xD; url 1..1 uri "unitPrice" #xD; value[x] 0..1 Money Fee, charge or cost per item #xD; extension:factor 0..1 Extension R4: Price scaling factor (new) #xD; url 1..1 uri "factor" #xD; value[x] 0..1 decimal Price scaling factor #xD; extension:net 0..1 Extension R4: Total item cost (new) #xD; url 1..1 uri "net" #xD; value[x] 0..1 Money Total item cost #xD; extension:noteNumber 0..* Extension R4: Applicable note numbers (new) #xD; url 1..1 uri "noteNumber" #xD; value[x] 0..1 positiveInt Applicable note numbers #xD; extension:adjudication 0..* Extension R4: Added items adjudication (new) #xD; url 1..1 uri "http://hl7.org/fhir/4.0/StructureDefinition/extension-ExplanationOfBenefit.item.adjudication" #xD; value[x] 0..0 Value of extension #xD; url 1..1 uri "http://hl7.org/fhir/4.0/StructureDefinition/extension-ExplanationOfBenefit.addItem.detail.subDetail" #xD; value[x] 0..0 Value of extension #xD; Documentation for this format
R4: `ExplanationOfBenefit.addItem.detail.subDetail` (new:BackboneElement)
This extension is part of the cross-version definitions generated to enable use of the element `ExplanationOfBenefit.addItem.detail.subDetail` as defined in FHIR R4 in FHIR STU3. The source element is defined as: `ExplanationOfBenefit.addItem.detail.subDetail` 0..* `BackboneElement` Following are the generation technical comments: Element `ExplanationOfBenefit.addItem.detail.subDetail` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
Element `ExplanationOfBenefit.addItem.detail.subDetail` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
R4: Billing, service, product, or drug code (new)
R4: `ExplanationOfBenefit.addItem.detail.subDetail.productOrService` (new:CodeableConcept)
Element `ExplanationOfBenefit.addItem.detail.subDetail.productOrService` is part of an existing definition because parent element `ExplanationOfBenefit.addItem.detail.subDetail` requires a cross-version extension. Element `ExplanationOfBenefit.addItem.detail.subDetail.productOrService` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail.productOrService` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
Necessary to state what was provided or done. Element `ExplanationOfBenefit.addItem.detail.subDetail.productOrService` is part of an existing definition because parent element `ExplanationOfBenefit.addItem.detail.subDetail` requires a cross-version extension. Element `ExplanationOfBenefit.addItem.detail.subDetail.productOrService` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail.productOrService` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
Additional Content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Source of the definition for the extension code - a logical name or a URL.
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.
If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
R4: Service/Product billing modifiers (new)
R4: `ExplanationOfBenefit.addItem.detail.subDetail.modifier` (new:CodeableConcept)
Element `ExplanationOfBenefit.addItem.detail.subDetail.modifier` is part of an existing definition because parent element `ExplanationOfBenefit.addItem.detail.subDetail` requires a cross-version extension. Element `ExplanationOfBenefit.addItem.detail.subDetail.modifier` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail.modifier` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.
To support inclusion of the item for adjudication or to charge an elevated fee. Element `ExplanationOfBenefit.addItem.detail.subDetail.modifier` is part of an existing definition because parent element `ExplanationOfBenefit.addItem.detail.subDetail` requires a cross-version extension. Element `ExplanationOfBenefit.addItem.detail.subDetail.modifier` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail.modifier` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
Item typification or modifiers codes to convey additional context for the product or service.
For example, in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.
Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
R4: `ExplanationOfBenefit.addItem.detail.subDetail.quantity` (new:Quantity[SimpleQuantity])
Element `ExplanationOfBenefit.addItem.detail.subDetail.quantity` is part of an existing definition because parent element `ExplanationOfBenefit.addItem.detail.subDetail` requires a cross-version extension. Element `ExplanationOfBenefit.addItem.detail.subDetail.quantity` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail.quantity` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
Required when the product or service code does not convey the quantity provided. Element `ExplanationOfBenefit.addItem.detail.subDetail.quantity` is part of an existing definition because parent element `ExplanationOfBenefit.addItem.detail.subDetail` requires a cross-version extension. Element `ExplanationOfBenefit.addItem.detail.subDetail.quantity` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail.quantity` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
The number of repetitions of a service or product.
R4: `ExplanationOfBenefit.addItem.detail.subDetail.unitPrice` (new:Money)
Element `ExplanationOfBenefit.addItem.detail.subDetail.unitPrice` is part of an existing definition because parent element `ExplanationOfBenefit.addItem.detail.subDetail` requires a cross-version extension. Element `ExplanationOfBenefit.addItem.detail.subDetail.unitPrice` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail.unitPrice` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
The amount charged to the patient by the provider for a single unit. Element `ExplanationOfBenefit.addItem.detail.subDetail.unitPrice` is part of an existing definition because parent element `ExplanationOfBenefit.addItem.detail.subDetail` requires a cross-version extension. Element `ExplanationOfBenefit.addItem.detail.subDetail.unitPrice` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail.unitPrice` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
R4: `ExplanationOfBenefit.addItem.detail.subDetail.factor` (new:decimal)
Element `ExplanationOfBenefit.addItem.detail.subDetail.factor` is part of an existing definition because parent element `ExplanationOfBenefit.addItem.detail.subDetail` requires a cross-version extension. Element `ExplanationOfBenefit.addItem.detail.subDetail.factor` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail.factor` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication. Element `ExplanationOfBenefit.addItem.detail.subDetail.factor` is part of an existing definition because parent element `ExplanationOfBenefit.addItem.detail.subDetail` requires a cross-version extension. Element `ExplanationOfBenefit.addItem.detail.subDetail.factor` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail.factor` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
R4: `ExplanationOfBenefit.addItem.detail.subDetail.net` (new:Money)
Element `ExplanationOfBenefit.addItem.detail.subDetail.net` is part of an existing definition because parent element `ExplanationOfBenefit.addItem.detail.subDetail` requires a cross-version extension. Element `ExplanationOfBenefit.addItem.detail.subDetail.net` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail.net` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
Provides the total amount claimed for the group (if a grouper) or the line item. Element `ExplanationOfBenefit.addItem.detail.subDetail.net` is part of an existing definition because parent element `ExplanationOfBenefit.addItem.detail.subDetail` requires a cross-version extension. Element `ExplanationOfBenefit.addItem.detail.subDetail.net` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail.net` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
The quantity times the unit price for an additional service or product or charge.
For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
R4: `ExplanationOfBenefit.addItem.detail.subDetail.noteNumber` (new:positiveInt)
Element `ExplanationOfBenefit.addItem.detail.subDetail.noteNumber` is part of an existing definition because parent element `ExplanationOfBenefit.addItem.detail.subDetail` requires a cross-version extension. Element `ExplanationOfBenefit.addItem.detail.subDetail.noteNumber` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail.noteNumber` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
Provides a condensed manner for associating human readable descriptive explanations for adjudications on the line item. Element `ExplanationOfBenefit.addItem.detail.subDetail.noteNumber` is part of an existing definition because parent element `ExplanationOfBenefit.addItem.detail.subDetail` requires a cross-version extension. Element `ExplanationOfBenefit.addItem.detail.subDetail.noteNumber` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail.noteNumber` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
The numbers associated with notes below which apply to the adjudication of this item.
R4: `ExplanationOfBenefit.addItem.detail.subDetail.adjudication` (new:ExplanationOfBenefit.item.adjudication)
Element `ExplanationOfBenefit.addItem.detail.subDetail.adjudication` is part of an existing definition because parent element `ExplanationOfBenefit.addItem.detail.subDetail` requires a cross-version extension. Element `ExplanationOfBenefit.addItem.detail.subDetail.adjudication` has a context of ExplanationOfBenefit.addItem.detail based on following the parent source element upwards and mapping to `ExplanationOfBenefit`. Element `ExplanationOfBenefit.addItem.detail.subDetail.adjudication` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).