Extensions for Using Data Elements from FHIR R4B in FHIR STU3
0.1.0 - STU
Extensions for Using Data Elements from FHIR R4B in FHIR STU3
0.1.0 - STU
Extensions for Using Data Elements from FHIR R4B in FHIR STU3 - Downloaded Version null See the Directory of published versions
| Official URL: http://hl7.org/fhir/uv/xver/ConceptMap/R4B-ClaimResponse-element-map-to-R3 | Version: 0.1.0 | |||
| Standards status: Trial-use | Maturity Level: 0 | Computable Name: R4BClaimResponseElementMapToR3 | ||
This ConceptMap represents cross-version mappings for elements from a FHIR R4B ClaimResponse to FHIR STU3.
Mapping from http://hl7.org/fhir/4.3 to http://hl7.org/fhir/3.0
Group 1 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to http://hl7.org/fhir/StructureDefinition/ClaimResponse|3.0.2
| Source Concept Details | Relationship | Target Concept Details | Comment | ||
| Codes from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 | Codes from http://hl7.org/fhir/StructureDefinition/ClaimResponse|3.0.2 | ||||
| ClaimResponse.meta | meta | maps to wider concept | ClaimResponse.meta | ClaimResponse.meta | Element `ClaimResponse.meta` is mapped to FHIR STU3 element `ClaimResponse.meta` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.meta` do not cover the following types: Meta. The mappings for `ClaimResponse.meta` do not cover the following types based on type expansion: lastUpdated, profile, security, source, tag, versionId. |
| ClaimResponse.implicitRules | implicitRules | is equivalent to | ClaimResponse.implicitRules | ClaimResponse.implicitRules | Element `ClaimResponse.implicitRules` is mapped to FHIR STU3 element `ClaimResponse.implicitRules` as `Equivalent`. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
| ClaimResponse.language | language | is equivalent to | ClaimResponse.language | ClaimResponse.language | Element `ClaimResponse.language` is mapped to FHIR STU3 element `ClaimResponse.language` as `Equivalent`. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). |
| ClaimResponse.text | text | maps to wider concept | ClaimResponse.text | ClaimResponse.text | Element `ClaimResponse.text` is mapped to FHIR STU3 element `ClaimResponse.text` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.text` do not cover the following types: Narrative. The mappings for `ClaimResponse.text` do not cover the following types based on type expansion: div, status. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. |
| ClaimResponse.contained | contained | is equivalent to | ClaimResponse.contained | ClaimResponse.contained | Element `ClaimResponse.contained` is mapped to FHIR STU3 element `ClaimResponse.contained` as `SourceIsBroaderThanTarget`. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. |
| ClaimResponse.identifier | identifier | maps to wider concept | ClaimResponse.identifier | ClaimResponse.identifier | Element `ClaimResponse.identifier` is mapped to FHIR STU3 element `ClaimResponse.identifier` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.identifier` do not cover the following types: Identifier. The mappings for `ClaimResponse.identifier` do not cover the following types based on type expansion: assigner, period, system, type, use, value. |
| ClaimResponse.status | status | is equivalent to | ClaimResponse.status | ClaimResponse.status | Element `ClaimResponse.status` is mapped to FHIR STU3 element `ClaimResponse.status` as `Equivalent`. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
| ClaimResponse.patient | patient | maps to wider concept | ClaimResponse.patient | ClaimResponse.patient | Element `ClaimResponse.patient` is mapped to FHIR STU3 element `ClaimResponse.patient` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.patient` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R4B element `ClaimResponse.patient` with unmapped reference targets: Patient. |
| ClaimResponse.created | created | is equivalent to | ClaimResponse.created | ClaimResponse.created | Element `ClaimResponse.created` is mapped to FHIR STU3 element `ClaimResponse.created` as `Equivalent`. |
| ClaimResponse.insurer | insurer | maps to wider concept | ClaimResponse.insurer | ClaimResponse.insurer | Element `ClaimResponse.insurer` is mapped to FHIR STU3 element `ClaimResponse.insurer` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.insurer` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R4B element `ClaimResponse.insurer` with unmapped reference targets: Organization. |
| ClaimResponse.requestor | requestor | is related to | ClaimResponse.requestOrganization | ClaimResponse.requestOrganization | Element `ClaimResponse.requestor` is mapped to FHIR STU3 element `ClaimResponse.requestProvider` as `SourceIsBroaderThanTarget`. Element `ClaimResponse.requestor` is mapped to FHIR STU3 element `ClaimResponse.requestOrganization` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R4B element `ClaimResponse.requestor` with unmapped reference targets: Organization, Practitioner, PractitionerRole. Typically this field would be 1..1 where this party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below. |
| is related to | ClaimResponse.requestProvider | ClaimResponse.requestProvider | Element `ClaimResponse.requestor` is mapped to FHIR STU3 element `ClaimResponse.requestProvider` as `SourceIsBroaderThanTarget`. Element `ClaimResponse.requestor` is mapped to FHIR STU3 element `ClaimResponse.requestOrganization` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R4B element `ClaimResponse.requestor` with unmapped reference targets: Organization, Practitioner, PractitionerRole. Typically this field would be 1..1 where this party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below. | ||
| ClaimResponse.request | request | maps to wider concept | ClaimResponse.request | ClaimResponse.request | Element `ClaimResponse.request` is mapped to FHIR STU3 element `ClaimResponse.request` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.request` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R4B element `ClaimResponse.request` with unmapped reference targets: Claim. |
| ClaimResponse.outcome | outcome | maps to wider concept | ClaimResponse.outcome | ClaimResponse.outcome | Element `ClaimResponse.outcome` is mapped to FHIR STU3 element `ClaimResponse.outcome` as `RelatedTo`. The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete). |
| ClaimResponse.disposition | disposition | is equivalent to | ClaimResponse.disposition | ClaimResponse.disposition | Element `ClaimResponse.disposition` is mapped to FHIR STU3 element `ClaimResponse.disposition` as `Equivalent`. |
| ClaimResponse.preAuthRef | preAuthRef | narrower | ClaimResponse.insurance.preAuthRef | ClaimResponse.insurance.preAuthRef | Element `ClaimResponse.preAuthRef` is mapped to FHIR STU3 element `ClaimResponse.insurance.preAuthRef` as `SourceIsNarrowerThanTarget`. This value is only present on preauthorization adjudications. |
| ClaimResponse.payeeType | payeeType | is equivalent to | ClaimResponse.payeeType | ClaimResponse.payeeType | Element `ClaimResponse.payeeType` is mapped to FHIR STU3 element `ClaimResponse.payeeType` as `Equivalent`. |
| ClaimResponse.item | item | maps to wider concept | ClaimResponse.item | ClaimResponse.item | Element `ClaimResponse.item` is mapped to FHIR STU3 element `ClaimResponse.item` as `Equivalent`. |
| ClaimResponse.item.itemSequence | itemSequence | is equivalent to | ClaimResponse.item.sequenceLinkId | ClaimResponse.item.sequenceLinkId | Element `ClaimResponse.item.itemSequence` is mapped to FHIR STU3 element `ClaimResponse.item.sequenceLinkId` as `Equivalent`. |
| ClaimResponse.item.noteNumber | noteNumber | is equivalent to | ClaimResponse.item.noteNumber | ClaimResponse.item.noteNumber | Element `ClaimResponse.item.noteNumber` is mapped to FHIR STU3 element `ClaimResponse.item.noteNumber` as `Equivalent`. |
| ClaimResponse.item.adjudication | adjudication | maps to wider concept | ClaimResponse.item.adjudication | ClaimResponse.item.adjudication | Element `ClaimResponse.item.adjudication` is mapped to FHIR STU3 element `ClaimResponse.item.adjudication` as `Equivalent`. |
| ClaimResponse.item.adjudication.category | category | is equivalent to | ClaimResponse.item.adjudication.category | ClaimResponse.item.adjudication.category | Element `ClaimResponse.item.adjudication.category` is mapped to FHIR STU3 element `ClaimResponse.item.adjudication.category` as `Equivalent`. For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc. |
| ClaimResponse.item.adjudication.reason | reason | is equivalent to | ClaimResponse.item.adjudication.reason | ClaimResponse.item.adjudication.reason | Element `ClaimResponse.item.adjudication.reason` is mapped to FHIR STU3 element `ClaimResponse.item.adjudication.reason` as `Equivalent`. For example may indicate that the funds for this benefit type have been exhausted. |
| ClaimResponse.item.adjudication.amount | amount | is equivalent to | ClaimResponse.item.adjudication.amount | ClaimResponse.item.adjudication.amount | Element `ClaimResponse.item.adjudication.amount` is mapped to FHIR STU3 element `ClaimResponse.item.adjudication.amount` as `Equivalent`. For example: amount submitted, eligible amount, co-payment, and benefit payable. |
| ClaimResponse.item.adjudication.value | value | is equivalent to | ClaimResponse.item.adjudication.value | ClaimResponse.item.adjudication.value | Element `ClaimResponse.item.adjudication.value` is mapped to FHIR STU3 element `ClaimResponse.item.adjudication.value` as `Equivalent`. For example: eligible percentage or co-payment percentage. |
| ClaimResponse.item.detail | detail | maps to wider concept | ClaimResponse.item.detail | ClaimResponse.item.detail | Element `ClaimResponse.item.detail` is mapped to FHIR STU3 element `ClaimResponse.item.detail` as `Equivalent`. |
| ClaimResponse.item.detail.detailSequence | detailSequence | is equivalent to | ClaimResponse.item.detail.sequenceLinkId | ClaimResponse.item.detail.sequenceLinkId | Element `ClaimResponse.item.detail.detailSequence` is mapped to FHIR STU3 element `ClaimResponse.item.detail.sequenceLinkId` as `Equivalent`. |
| ClaimResponse.item.detail.noteNumber | noteNumber | is equivalent to | ClaimResponse.item.detail.noteNumber | ClaimResponse.item.detail.noteNumber | Element `ClaimResponse.item.detail.noteNumber` is mapped to FHIR STU3 element `ClaimResponse.item.detail.noteNumber` as `Equivalent`. |
| ClaimResponse.item.detail.adjudication | adjudication | is equivalent to | ClaimResponse.item.detail.adjudication | ClaimResponse.item.detail.adjudication | Element `ClaimResponse.item.detail.adjudication` is mapped to FHIR STU3 element `ClaimResponse.item.detail.adjudication` as `Equivalent`. |
| ClaimResponse.item.detail.subDetail | subDetail | maps to wider concept | ClaimResponse.item.detail.subDetail | ClaimResponse.item.detail.subDetail | Element `ClaimResponse.item.detail.subDetail` is mapped to FHIR STU3 element `ClaimResponse.item.detail.subDetail` as `Equivalent`. |
| ClaimResponse.item.detail.subDetail.subDetailSequence | subDetailSequence | is equivalent to | ClaimResponse.item.detail.subDetail.sequenceLinkId | ClaimResponse.item.detail.subDetail.sequenceLinkId | Element `ClaimResponse.item.detail.subDetail.subDetailSequence` is mapped to FHIR STU3 element `ClaimResponse.item.detail.subDetail.sequenceLinkId` as `Equivalent`. |
| ClaimResponse.item.detail.subDetail.noteNumber | noteNumber | is equivalent to | ClaimResponse.item.detail.subDetail.noteNumber | ClaimResponse.item.detail.subDetail.noteNumber | Element `ClaimResponse.item.detail.subDetail.noteNumber` is mapped to FHIR STU3 element `ClaimResponse.item.detail.subDetail.noteNumber` as `Equivalent`. |
| ClaimResponse.item.detail.subDetail.adjudication | adjudication | is equivalent to | ClaimResponse.item.detail.subDetail.adjudication | ClaimResponse.item.detail.subDetail.adjudication | Element `ClaimResponse.item.detail.subDetail.adjudication` is mapped to FHIR STU3 element `ClaimResponse.item.detail.subDetail.adjudication` as `Equivalent`. |
| ClaimResponse.addItem | addItem | maps to wider concept | ClaimResponse.addItem | ClaimResponse.addItem | Element `ClaimResponse.addItem` is mapped to FHIR STU3 element `ClaimResponse.addItem` as `Equivalent`. |
| ClaimResponse.addItem.itemSequence | itemSequence | is equivalent to | ClaimResponse.addItem.sequenceLinkId | ClaimResponse.addItem.sequenceLinkId | Element `ClaimResponse.addItem.itemSequence` is mapped to FHIR STU3 element `ClaimResponse.addItem.sequenceLinkId` as `Equivalent`. |
| ClaimResponse.addItem.productOrService | productOrService | is equivalent to | ClaimResponse.addItem.service | ClaimResponse.addItem.service | Element `ClaimResponse.addItem.productOrService` is mapped to FHIR STU3 element `ClaimResponse.addItem.service` as `Equivalent`. 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'. |
| ClaimResponse.addItem.modifier | modifier | is equivalent to | ClaimResponse.addItem.modifier | ClaimResponse.addItem.modifier | Element `ClaimResponse.addItem.modifier` is mapped to FHIR STU3 element `ClaimResponse.addItem.modifier` as `Equivalent`. For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours. |
| ClaimResponse.addItem.net | net | is equivalent to | ClaimResponse.addItem.fee | ClaimResponse.addItem.fee | Element `ClaimResponse.addItem.net` is mapped to FHIR STU3 element `ClaimResponse.addItem.fee` as `Equivalent`. For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied. |
| ClaimResponse.addItem.noteNumber | noteNumber | is equivalent to | ClaimResponse.addItem.noteNumber | ClaimResponse.addItem.noteNumber | Element `ClaimResponse.addItem.noteNumber` is mapped to FHIR STU3 element `ClaimResponse.addItem.noteNumber` as `Equivalent`. |
| ClaimResponse.addItem.adjudication | adjudication | is equivalent to | ClaimResponse.addItem.adjudication | ClaimResponse.addItem.adjudication | Element `ClaimResponse.addItem.adjudication` is mapped to FHIR STU3 element `ClaimResponse.addItem.adjudication` as `Equivalent`. |
| ClaimResponse.addItem.detail | detail | maps to wider concept | ClaimResponse.addItem.detail | ClaimResponse.addItem.detail | Element `ClaimResponse.addItem.detail` is mapped to FHIR STU3 element `ClaimResponse.addItem.detail` as `Equivalent`. |
| ClaimResponse.addItem.detail.productOrService | productOrService | is equivalent to | ClaimResponse.addItem.detail.service | ClaimResponse.addItem.detail.service | Element `ClaimResponse.addItem.detail.productOrService` is mapped to FHIR STU3 element `ClaimResponse.addItem.detail.service` as `Equivalent`. 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'. |
| ClaimResponse.addItem.detail.modifier | modifier | is equivalent to | ClaimResponse.addItem.detail.modifier | ClaimResponse.addItem.detail.modifier | Element `ClaimResponse.addItem.detail.modifier` is mapped to FHIR STU3 element `ClaimResponse.addItem.detail.modifier` as `Equivalent`. For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours. |
| ClaimResponse.addItem.detail.noteNumber | noteNumber | is equivalent to | ClaimResponse.addItem.detail.noteNumber | ClaimResponse.addItem.detail.noteNumber | Element `ClaimResponse.addItem.detail.noteNumber` is mapped to FHIR STU3 element `ClaimResponse.addItem.detail.noteNumber` as `Equivalent`. |
| ClaimResponse.addItem.detail.adjudication | adjudication | is equivalent to | ClaimResponse.addItem.detail.adjudication | ClaimResponse.addItem.detail.adjudication | Element `ClaimResponse.addItem.detail.adjudication` is mapped to FHIR STU3 element `ClaimResponse.addItem.detail.adjudication` as `Equivalent`. |
| ClaimResponse.total.amount | amount | is related to | ClaimResponse.totalBenefit | ClaimResponse.totalBenefit | Element `ClaimResponse.total.amount` is part of an existing definition because parent element `ClaimResponse.total` requires a cross-version extension. Element `ClaimResponse.total.amount` is mapped to FHIR STU3 element `ClaimResponse.totalCost` as `SourceIsBroaderThanTarget`. Element `ClaimResponse.total.amount` is mapped to FHIR STU3 element `ClaimResponse.totalBenefit` as `SourceIsBroaderThanTarget`. |
| is related to | ClaimResponse.totalCost | ClaimResponse.totalCost | Element `ClaimResponse.total.amount` is part of an existing definition because parent element `ClaimResponse.total` requires a cross-version extension. Element `ClaimResponse.total.amount` is mapped to FHIR STU3 element `ClaimResponse.totalCost` as `SourceIsBroaderThanTarget`. Element `ClaimResponse.total.amount` is mapped to FHIR STU3 element `ClaimResponse.totalBenefit` as `SourceIsBroaderThanTarget`. | ||
| ClaimResponse.payment | payment | maps to wider concept | ClaimResponse.payment | ClaimResponse.payment | Element `ClaimResponse.payment` is mapped to FHIR STU3 element `ClaimResponse.payment` as `Equivalent`. |
| ClaimResponse.payment.type | type | is equivalent to | ClaimResponse.payment.type | ClaimResponse.payment.type | Element `ClaimResponse.payment.type` is mapped to FHIR STU3 element `ClaimResponse.payment.type` as `Equivalent`. |
| ClaimResponse.payment.adjustment | adjustment | is equivalent to | ClaimResponse.payment.adjustment | ClaimResponse.payment.adjustment | Element `ClaimResponse.payment.adjustment` is mapped to FHIR STU3 element `ClaimResponse.payment.adjustment` as `Equivalent`. Insurers will deduct amounts owing from the provider (adjustment), such as a prior overpayment, from the amount owing to the provider (benefits payable) when payment is made to the provider. |
| ClaimResponse.payment.adjustmentReason | adjustmentReason | is equivalent to | ClaimResponse.payment.adjustmentReason | ClaimResponse.payment.adjustmentReason | Element `ClaimResponse.payment.adjustmentReason` is mapped to FHIR STU3 element `ClaimResponse.payment.adjustmentReason` as `Equivalent`. |
| ClaimResponse.payment.date | date | is equivalent to | ClaimResponse.payment.date | ClaimResponse.payment.date | Element `ClaimResponse.payment.date` is mapped to FHIR STU3 element `ClaimResponse.payment.date` as `Equivalent`. |
| ClaimResponse.payment.amount | amount | is equivalent to | ClaimResponse.payment.amount | ClaimResponse.payment.amount | Element `ClaimResponse.payment.amount` is mapped to FHIR STU3 element `ClaimResponse.payment.amount` as `Equivalent`. |
| ClaimResponse.payment.identifier | identifier | maps to wider concept | ClaimResponse.payment.identifier | ClaimResponse.payment.identifier | Element `ClaimResponse.payment.identifier` is mapped to FHIR STU3 element `ClaimResponse.payment.identifier` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.payment.identifier` do not cover the following types: Identifier. The mappings for `ClaimResponse.payment.identifier` do not cover the following types based on type expansion: assigner, period, system, type, use, value. For example: EFT number or check number. |
| ClaimResponse.fundsReserve | fundsReserve | maps to wider concept | ClaimResponse.reserved | ClaimResponse.reserved | Element `ClaimResponse.fundsReserve` is mapped to FHIR STU3 element `ClaimResponse.reserved` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.fundsReserve` do not cover the following types: CodeableConcept. The mappings for `ClaimResponse.fundsReserve` do not cover the following types based on type expansion: text. Fund would be release by a future claim quoting the preAuthRef of this response. Examples of values include: provider, patient, none. |
| ClaimResponse.formCode | formCode | is equivalent to | ClaimResponse.form | ClaimResponse.form | Element `ClaimResponse.formCode` is mapped to FHIR STU3 element `ClaimResponse.form` as `Equivalent`. May be needed to identify specific jurisdictional forms. |
| ClaimResponse.form | form | maps to wider concept | ClaimResponse.form | ClaimResponse.form | Element `ClaimResponse.form` is mapped to FHIR STU3 element `ClaimResponse.form` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.form` do not cover the following types: Attachment. The mappings for `ClaimResponse.form` do not cover the following types based on type expansion: creation, data, hash, size, title, url. Needed to permit insurers to include the actual form. |
| ClaimResponse.processNote | processNote | maps to wider concept | ClaimResponse.processNote | ClaimResponse.processNote | Element `ClaimResponse.processNote` is mapped to FHIR STU3 element `ClaimResponse.processNote` as `Equivalent`. |
| ClaimResponse.processNote.number | number | is equivalent to | ClaimResponse.processNote.number | ClaimResponse.processNote.number | Element `ClaimResponse.processNote.number` is mapped to FHIR STU3 element `ClaimResponse.processNote.number` as `Equivalent`. |
| ClaimResponse.processNote.type | type | is equivalent to | ClaimResponse.processNote.type | ClaimResponse.processNote.type | Element `ClaimResponse.processNote.type` is mapped to FHIR STU3 element `ClaimResponse.processNote.type` as `SourceIsNarrowerThanTarget`. |
| ClaimResponse.processNote.text | text | is equivalent to | ClaimResponse.processNote.text | ClaimResponse.processNote.text | Element `ClaimResponse.processNote.text` is mapped to FHIR STU3 element `ClaimResponse.processNote.text` as `Equivalent`. |
| ClaimResponse.processNote.language | language | is equivalent to | ClaimResponse.processNote.language | ClaimResponse.processNote.language | Element `ClaimResponse.processNote.language` is mapped to FHIR STU3 element `ClaimResponse.processNote.language` as `Equivalent`. Only required if the language is different from the resource language. |
| ClaimResponse.communicationRequest | communicationRequest | maps to wider concept | ClaimResponse.communicationRequest | ClaimResponse.communicationRequest | Element `ClaimResponse.communicationRequest` is mapped to FHIR STU3 element `ClaimResponse.communicationRequest` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.communicationRequest` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R4B element `ClaimResponse.communicationRequest` with unmapped reference targets: CommunicationRequest. For example: professional reports, documents, images, clinical resources, or accident reports. |
| ClaimResponse.insurance | insurance | maps to wider concept | ClaimResponse.insurance | ClaimResponse.insurance | Element `ClaimResponse.insurance` is mapped to FHIR STU3 element `ClaimResponse.insurance` as `Equivalent`. All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim. |
| ClaimResponse.insurance.sequence | sequence | is equivalent to | ClaimResponse.insurance.sequence | ClaimResponse.insurance.sequence | Element `ClaimResponse.insurance.sequence` is mapped to FHIR STU3 element `ClaimResponse.insurance.sequence` as `Equivalent`. |
| ClaimResponse.insurance.focal | focal | is equivalent to | ClaimResponse.insurance.focal | ClaimResponse.insurance.focal | Element `ClaimResponse.insurance.focal` is mapped to FHIR STU3 element `ClaimResponse.insurance.focal` as `Equivalent`. A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies. |
| ClaimResponse.insurance.coverage | coverage | maps to wider concept | ClaimResponse.insurance.coverage | ClaimResponse.insurance.coverage | Element `ClaimResponse.insurance.coverage` is mapped to FHIR STU3 element `ClaimResponse.insurance.coverage` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.insurance.coverage` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R4B element `ClaimResponse.insurance.coverage` with unmapped reference targets: Coverage. |
| ClaimResponse.insurance.businessArrangement | businessArrangement | is equivalent to | ClaimResponse.insurance.businessArrangement | ClaimResponse.insurance.businessArrangement | Element `ClaimResponse.insurance.businessArrangement` is mapped to FHIR STU3 element `ClaimResponse.insurance.businessArrangement` as `Equivalent`. |
| ClaimResponse.insurance.claimResponse | claimResponse | maps to wider concept | ClaimResponse.insurance.claimResponse | ClaimResponse.insurance.claimResponse | Element `ClaimResponse.insurance.claimResponse` is mapped to FHIR STU3 element `ClaimResponse.insurance.claimResponse` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.insurance.claimResponse` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R4B element `ClaimResponse.insurance.claimResponse` with unmapped reference targets: ClaimResponse. Must not be specified when 'focal=true' for this insurance. |
| ClaimResponse.error | error | maps to wider concept | ClaimResponse.error | ClaimResponse.error | Element `ClaimResponse.error` is mapped to FHIR STU3 element `ClaimResponse.error` as `Equivalent`. If the request contains errors then an error element should be provided and no adjudication related sections (item, addItem, or payment) should be present. |
| ClaimResponse.error.itemSequence | itemSequence | is equivalent to | ClaimResponse.error.sequenceLinkId | ClaimResponse.error.sequenceLinkId | Element `ClaimResponse.error.itemSequence` is mapped to FHIR STU3 element `ClaimResponse.error.sequenceLinkId` as `Equivalent`. |
| ClaimResponse.error.detailSequence | detailSequence | is equivalent to | ClaimResponse.error.detailSequenceLinkId | ClaimResponse.error.detailSequenceLinkId | Element `ClaimResponse.error.detailSequence` is mapped to FHIR STU3 element `ClaimResponse.error.detailSequenceLinkId` as `Equivalent`. |
| ClaimResponse.error.subDetailSequence | subDetailSequence | is equivalent to | ClaimResponse.error.subdetailSequenceLinkId | ClaimResponse.error.subdetailSequenceLinkId | Element `ClaimResponse.error.subDetailSequence` is mapped to FHIR STU3 element `ClaimResponse.error.subdetailSequenceLinkId` as `Equivalent`. |
| ClaimResponse.error.code | code | is equivalent to | ClaimResponse.error.code | ClaimResponse.error.code | Element `ClaimResponse.error.code` is mapped to FHIR STU3 element `ClaimResponse.error.code` as `Equivalent`. |
Group 2 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: meta additional typesversion: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.meta (meta) | is equivalent to | Extension (R4B: meta additional types) | Element `ClaimResponse.meta` is mapped to FHIR STU3 element `ClaimResponse.meta` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.meta` do not cover the following types: Meta. The mappings for `ClaimResponse.meta` do not cover the following types based on type expansion: lastUpdated, profile, security, source, tag, versionId. |
Group 3 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: text additional typesversion: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.text (text) | is equivalent to | Extension (R4B: text additional types) | Element `ClaimResponse.text` is mapped to FHIR STU3 element `ClaimResponse.text` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.text` do not cover the following types: Narrative. The mappings for `ClaimResponse.text` do not cover the following types based on type expansion: div, status. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. |
Group 4 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Business Identifier for a claim response additional typesversion: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.identifier (identifier) | is equivalent to | Extension (R4B: Business Identifier for a claim response additional types) | Element `ClaimResponse.identifier` is mapped to FHIR STU3 element `ClaimResponse.identifier` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.identifier` do not cover the following types: Identifier. The mappings for `ClaimResponse.identifier` do not cover the following types based on type expansion: assigner, period, system, type, use, value. |
Group 5 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: More granular claim type (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.type (type) | is equivalent to | Extension (R4B: More granular claim type (new)) | Element `ClaimResponse.type` has a context of ClaimResponse based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.type` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type. |
Group 6 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: More granular claim type (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.subType (subType) | is equivalent to | Extension (R4B: More granular claim type (new)) | Element `ClaimResponse.subType` has a context of ClaimResponse based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.subType` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type. |
Group 7 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: claim | preauthorization | predetermination (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.use (use) | is equivalent to | Extension (R4B: claim | preauthorization | predetermination (new)) | Element `ClaimResponse.use` has a context of ClaimResponse based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.use` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
Group 8 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: queued | complete | error | partialversion: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.outcome (outcome) | is equivalent to | Extension (R4B: queued | complete | error | partial) | Element `ClaimResponse.outcome` is mapped to FHIR STU3 element `ClaimResponse.outcome` as `RelatedTo`. The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete). |
Group 9 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Preauthorization reference effective period (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.preAuthPeriod (preAuthPeriod) | is equivalent to | Extension (R4B: Preauthorization reference effective period (new)) | Element `ClaimResponse.preAuthPeriod` has a context of ClaimResponse based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.preAuthPeriod` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
Group 10 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: adjudicationversion: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.item.adjudication (adjudication) | is equivalent to | Extension (R4B: adjudication) | Element `ClaimResponse.item.adjudication` is mapped to FHIR STU3 element `ClaimResponse.item.adjudication` as `Equivalent`. |
| ClaimResponse.item.adjudication.category (category) | is equivalent to | Extension.extension:category (R4B: Type of adjudication information) | Element `ClaimResponse.item.adjudication.category` is mapped to FHIR STU3 element `ClaimResponse.item.adjudication.category` as `Equivalent`. For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc. |
| ClaimResponse.item.adjudication.reason (reason) | is equivalent to | Extension.extension:reason (R4B: Explanation of adjudication outcome) | Element `ClaimResponse.item.adjudication.reason` is mapped to FHIR STU3 element `ClaimResponse.item.adjudication.reason` as `Equivalent`. For example may indicate that the funds for this benefit type have been exhausted. |
| ClaimResponse.item.adjudication.amount (amount) | is equivalent to | Extension.extension:amount (R4B: amount) | Element `ClaimResponse.item.adjudication.amount` is mapped to FHIR STU3 element `ClaimResponse.item.adjudication.amount` as `Equivalent`. For example: amount submitted, eligible amount, co-payment, and benefit payable. |
| ClaimResponse.item.adjudication.value (value) | is equivalent to | Extension.extension:value (R4B: value) | Element `ClaimResponse.item.adjudication.value` is mapped to FHIR STU3 element `ClaimResponse.item.adjudication.value` as `Equivalent`. For example: eligible percentage or co-payment percentage. |
| ClaimResponse.addItem.detail.subDetail.adjudication (adjudication) | is equivalent to | Extension.extension:adjudication | Element `ClaimResponse.addItem.detail.subDetail.adjudication` is part of an existing definition because parent element `ClaimResponse.addItem.detail.subDetail` requires a cross-version extension. Element `ClaimResponse.addItem.detail.subDetail.adjudication` has a context of ClaimResponse.addItem.detail based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.detail.subDetail.adjudication` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
Group 11 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Detail sequence number (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.detailSequence (detailSequence) | is equivalent to | Extension (R4B: Detail sequence number (new)) | Element `ClaimResponse.addItem.detailSequence` has a context of ClaimResponse.addItem based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.detailSequence` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
Group 12 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Subdetail sequence number (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.subdetailSequence (subdetailSequence) | is equivalent to | Extension (R4B: Subdetail sequence number (new)) | Element `ClaimResponse.addItem.subdetailSequence` has a context of ClaimResponse.addItem based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.subdetailSequence` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
Group 13 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Authorized providers (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.provider (provider) | is equivalent to | Extension (R4B: Authorized providers (new)) | Element `ClaimResponse.addItem.provider` has a context of ClaimResponse.addItem based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.provider` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
Group 14 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Program the product or service is provided under (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.programCode (programCode) | is equivalent to | Extension (R4B: Program the product or service is provided under (new)) | Element `ClaimResponse.addItem.programCode` has a context of ClaimResponse.addItem based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.programCode` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For example: Neonatal program, child dental program or drug users recovery program. |
Group 15 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Date or dates of service or product delivery (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.serviced[x] (serviced[x]) | is equivalent to | Extension (R4B: Date or dates of service or product delivery (new)) | Element `ClaimResponse.addItem.serviced[x]` has a context of ClaimResponse.addItem based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.serviced[x]` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
Group 16 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Place of service or where product was supplied (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.location[x] (location[x]) | is equivalent to | Extension (R4B: Place of service or where product was supplied (new)) | Element `ClaimResponse.addItem.location[x]` has a context of ClaimResponse.addItem based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.location[x]` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
Group 17 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Count of products or services (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.quantity (quantity) | is equivalent to | Extension (R4B: Count of products or services (new)) | Element `ClaimResponse.addItem.quantity` has a context of ClaimResponse.addItem based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.quantity` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
Group 18 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Fee, charge or cost per item (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.unitPrice (unitPrice) | is equivalent to | Extension (R4B: Fee, charge or cost per item (new)) | Element `ClaimResponse.addItem.unitPrice` has a context of ClaimResponse.addItem based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.unitPrice` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
Group 19 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Price scaling factor (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.factor (factor) | is equivalent to | Extension (R4B: Price scaling factor (new)) | Element `ClaimResponse.addItem.factor` has a context of ClaimResponse.addItem based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.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). |
Group 20 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Anatomical location (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.bodySite (bodySite) | is equivalent to | Extension (R4B: Anatomical location (new)) | Element `ClaimResponse.addItem.bodySite` has a context of ClaimResponse.addItem based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.bodySite` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For example: Providing a tooth code allows an insurer to identify a provider performing a filling on a tooth that was previously removed. |
Group 21 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Anatomical sub-location (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.subSite (subSite) | is equivalent to | Extension (R4B: Anatomical sub-location (new)) | Element `ClaimResponse.addItem.subSite` has a context of ClaimResponse.addItem based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.subSite` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
Group 22 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Count of products or services (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.detail.quantity (quantity) | is equivalent to | Extension (R4B: Count of products or services (new)) | Element `ClaimResponse.addItem.detail.quantity` has a context of ClaimResponse.addItem.detail based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.detail.quantity` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
Group 23 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Fee, charge or cost per item (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.detail.unitPrice (unitPrice) | is equivalent to | Extension (R4B: Fee, charge or cost per item (new)) | Element `ClaimResponse.addItem.detail.unitPrice` has a context of ClaimResponse.addItem.detail based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.detail.unitPrice` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
Group 24 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Price scaling factor (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.detail.factor (factor) | is equivalent to | Extension (R4B: Price scaling factor (new)) | Element `ClaimResponse.addItem.detail.factor` has a context of ClaimResponse.addItem.detail based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.detail.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). |
Group 25 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Total item cost (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.detail.net (net) | is equivalent to | Extension (R4B: Total item cost (new)) | Element `ClaimResponse.addItem.detail.net` has a context of ClaimResponse.addItem.detail based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.detail.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. |
Group 26 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Insurer added line items (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.addItem.detail.subDetail (subDetail) | is equivalent to | Extension (R4B: Insurer added line items (new)) | Element `ClaimResponse.addItem.detail.subDetail` has a context of ClaimResponse.addItem.detail based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.detail.subDetail` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
| ClaimResponse.addItem.detail.subDetail.productOrService (productOrService) | is equivalent to | Extension.extension:productOrService (R4B: Billing, service, product, or drug code (new)) | Element `ClaimResponse.addItem.detail.subDetail.productOrService` is part of an existing definition because parent element `ClaimResponse.addItem.detail.subDetail` requires a cross-version extension. Element `ClaimResponse.addItem.detail.subDetail.productOrService` has a context of ClaimResponse.addItem.detail based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.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'. |
| ClaimResponse.addItem.detail.subDetail.modifier (modifier) | is equivalent to | Extension.extension:modifier (R4B: Service/Product billing modifiers (new)) | Element `ClaimResponse.addItem.detail.subDetail.modifier` is part of an existing definition because parent element `ClaimResponse.addItem.detail.subDetail` requires a cross-version extension. Element `ClaimResponse.addItem.detail.subDetail.modifier` has a context of ClaimResponse.addItem.detail based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.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 outside of office hours. |
| ClaimResponse.addItem.detail.subDetail.quantity (quantity) | is equivalent to | Extension.extension:quantity (R4B: Count of products or services (new)) | Element `ClaimResponse.addItem.detail.subDetail.quantity` is part of an existing definition because parent element `ClaimResponse.addItem.detail.subDetail` requires a cross-version extension. Element `ClaimResponse.addItem.detail.subDetail.quantity` has a context of ClaimResponse.addItem.detail based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.detail.subDetail.quantity` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
| ClaimResponse.addItem.detail.subDetail.unitPrice (unitPrice) | is equivalent to | Extension.extension:unitPrice (R4B: Fee, charge or cost per item (new)) | Element `ClaimResponse.addItem.detail.subDetail.unitPrice` is part of an existing definition because parent element `ClaimResponse.addItem.detail.subDetail` requires a cross-version extension. Element `ClaimResponse.addItem.detail.subDetail.unitPrice` has a context of ClaimResponse.addItem.detail based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.detail.subDetail.unitPrice` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
| ClaimResponse.addItem.detail.subDetail.factor (factor) | is equivalent to | Extension.extension:factor (R4B: Price scaling factor (new)) | Element `ClaimResponse.addItem.detail.subDetail.factor` is part of an existing definition because parent element `ClaimResponse.addItem.detail.subDetail` requires a cross-version extension. Element `ClaimResponse.addItem.detail.subDetail.factor` has a context of ClaimResponse.addItem.detail based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.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). |
| ClaimResponse.addItem.detail.subDetail.net (net) | is equivalent to | Extension.extension:net (R4B: Total item cost (new)) | Element `ClaimResponse.addItem.detail.subDetail.net` is part of an existing definition because parent element `ClaimResponse.addItem.detail.subDetail` requires a cross-version extension. Element `ClaimResponse.addItem.detail.subDetail.net` has a context of ClaimResponse.addItem.detail based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.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. |
| ClaimResponse.addItem.detail.subDetail.noteNumber (noteNumber) | is equivalent to | Extension.extension:noteNumber (R4B: Applicable note numbers (new)) | Element `ClaimResponse.addItem.detail.subDetail.noteNumber` is part of an existing definition because parent element `ClaimResponse.addItem.detail.subDetail` requires a cross-version extension. Element `ClaimResponse.addItem.detail.subDetail.noteNumber` has a context of ClaimResponse.addItem.detail based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.detail.subDetail.noteNumber` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
| ClaimResponse.addItem.detail.subDetail.adjudication (adjudication) | is equivalent to | Extension.extension:adjudication (R4B: Added items detail adjudication (new)) | Element `ClaimResponse.addItem.detail.subDetail.adjudication` is part of an existing definition because parent element `ClaimResponse.addItem.detail.subDetail` requires a cross-version extension. Element `ClaimResponse.addItem.detail.subDetail.adjudication` has a context of ClaimResponse.addItem.detail based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.addItem.detail.subDetail.adjudication` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). |
Group 27 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Adjudication totals (new)version: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.total (total) | is equivalent to | Extension (R4B: Adjudication totals (new)) | Element `ClaimResponse.total` has a context of ClaimResponse based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.total` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Totals for amounts submitted, co-pays, benefits payable etc. |
| ClaimResponse.total.category (category) | is equivalent to | Extension.extension:category (R4B: Type of adjudication information (new)) | Element `ClaimResponse.total.category` is part of an existing definition because parent element `ClaimResponse.total` requires a cross-version extension. Element `ClaimResponse.total.category` has a context of ClaimResponse based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.total.category` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For example codes indicating: Co-Pay, deductible, eligible, benefit, tax, etc. |
| ClaimResponse.total.amount (amount) | maps to wider concept | Extension.extension:amount (R4B: Financial total for the category) | Element `ClaimResponse.total.amount` is part of an existing definition because parent element `ClaimResponse.total` requires a cross-version extension. Element `ClaimResponse.total.amount` is mapped to FHIR STU3 element `ClaimResponse.totalCost` as `SourceIsBroaderThanTarget`. Element `ClaimResponse.total.amount` is mapped to FHIR STU3 element `ClaimResponse.totalBenefit` as `SourceIsBroaderThanTarget`. |
Group 28 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Business identifier for the payment additional typesversion: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.payment.identifier (identifier) | is equivalent to | Extension (R4B: Business identifier for the payment additional types) | Element `ClaimResponse.payment.identifier` is mapped to FHIR STU3 element `ClaimResponse.payment.identifier` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.payment.identifier` do not cover the following types: Identifier. The mappings for `ClaimResponse.payment.identifier` do not cover the following types based on type expansion: assigner, period, system, type, use, value. For example: EFT number or check number. |
Group 29 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: fundsReserve additional typesversion: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.fundsReserve (fundsReserve) | maps to wider concept | Extension (R4B: fundsReserve additional types) | Element `ClaimResponse.fundsReserve` is mapped to FHIR STU3 element `ClaimResponse.reserved` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.fundsReserve` do not cover the following types: CodeableConcept. The mappings for `ClaimResponse.fundsReserve` do not cover the following types based on type expansion: text. Fund would be release by a future claim quoting the preAuthRef of this response. Examples of values include: provider, patient, none. |
Group 30 Mapping from http://hl7.org/fhir/StructureDefinition/ClaimResponse|4.3.0 to R4B: Printed reference or actual form additional typesversion: 0.1.0)
| Source Code | Relationship | Target Code | Comment |
| ClaimResponse.form (form) | is equivalent to | Extension (R4B: Printed reference or actual form additional types) | Element `ClaimResponse.form` is mapped to FHIR STU3 element `ClaimResponse.form` as `SourceIsBroaderThanTarget`. The mappings for `ClaimResponse.form` do not cover the following types: Attachment. The mappings for `ClaimResponse.form` do not cover the following types based on type expansion: creation, data, hash, size, title, url. Needed to permit insurers to include the actual form. |
IG © 2025+ FHIR Infrastructure. Package hl7.fhir.uv.xver-r4b.r3#0.1.0 based on FHIR 3.0.2. Generated 2026-03-20
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