R5CoverageEligibilityResponseElementMapToR3 - Extensions for Using Data Elements from FHIR R5 in FHIR STU3 v0.1.0

Extensions for Using Data Elements from FHIR R5 in FHIR STU3 - Downloaded Version null See the Directory of published versions

ConceptMap: R5CoverageEligibilityResponseElementMapToR3

Official URL: http://hl7.org/fhir/uv/xver/ConceptMap/R5-CoverageEligibilityResponse-element-map-to-R3				Version: 0.1.0
Standards status: Trial-use		Maturity Level: 0	Computable Name: R5CoverageEligibilityResponseElementMapToR3

This ConceptMap represents cross-version mappings for elements from a FHIR R5 CoverageEligibilityResponse to FHIR STU3.

Mapping from http://hl7.org/fhir/5.0 to http://hl7.org/fhir/3.0

Group 1 Mapping from http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse|5.0.0 to http://hl7.org/fhir/StructureDefinition/EligibilityResponse|3.0.2

Source Concept Details

Relationship

Target Concept Details

Comment

Codes from http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse|5.0.0

Codes from http://hl7.org/fhir/StructureDefinition/EligibilityResponse|3.0.2

CoverageEligibilityResponse.meta

meta

is equivalent to

EligibilityResponse.meta

Element `CoverageEligibilityResponse.meta` is mapped to FHIR STU3 element `EligibilityResponse.meta` as `Equivalent`.

CoverageEligibilityResponse.implicitRules

implicitRules

is equivalent to

EligibilityResponse.implicitRules

Element `CoverageEligibilityResponse.implicitRules` is mapped to FHIR STU3 element `EligibilityResponse.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 its narrative along with other profiles, value sets, etc.

CoverageEligibilityResponse.language

language

is equivalent to

EligibilityResponse.language

Element `CoverageEligibilityResponse.language` is mapped to FHIR STU3 element `EligibilityResponse.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).

CoverageEligibilityResponse.text

text

is equivalent to

EligibilityResponse.text

Element `CoverageEligibilityResponse.text` is mapped to FHIR STU3 element `EligibilityResponse.text` as `Equivalent`. Contained resources do not have a 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.

CoverageEligibilityResponse.contained

contained

is equivalent to

EligibilityResponse.contained

Element `CoverageEligibilityResponse.contained` is mapped to FHIR STU3 element `EligibilityResponse.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.

CoverageEligibilityResponse.identifier

identifier

is equivalent to

EligibilityResponse.identifier

Element `CoverageEligibilityResponse.identifier` is mapped to FHIR STU3 element `EligibilityResponse.identifier` as `Equivalent`.

CoverageEligibilityResponse.status

status

is equivalent to

EligibilityResponse.status

Element `CoverageEligibilityResponse.status` is mapped to FHIR STU3 element `EligibilityResponse.status` as `Equivalent`. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

CoverageEligibilityResponse.created

created

is equivalent to

EligibilityResponse.created

Element `CoverageEligibilityResponse.created` is mapped to FHIR STU3 element `EligibilityResponse.created` as `Equivalent`.

CoverageEligibilityResponse.requestor

requestor

is related to

EligibilityResponse.requestOrganization

Element `CoverageEligibilityResponse.requestor` is mapped to FHIR STU3 element `EligibilityResponse.requestProvider` as `SourceIsBroaderThanTarget`. Element `CoverageEligibilityResponse.requestor` is mapped to FHIR STU3 element `EligibilityResponse.requestOrganization` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `CoverageEligibilityResponse.requestor` with unmapped reference targets: Organization, Practitioner, PractitionerRole. This party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below. This field is the Billing Provider, for example, a facility, provider group, lab or practitioner.

is related to

EligibilityResponse.requestProvider

CoverageEligibilityResponse.request

request

maps to wider concept

EligibilityResponse.request

Element `CoverageEligibilityResponse.request` is mapped to FHIR STU3 element `EligibilityResponse.request` as `SourceIsBroaderThanTarget`. The mappings for `CoverageEligibilityResponse.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 R5 element `CoverageEligibilityResponse.request` with unmapped reference targets: CoverageEligibilityRequest.

CoverageEligibilityResponse.outcome

outcome

is related to

EligibilityResponse.outcome

Element `CoverageEligibilityResponse.outcome` is mapped to FHIR STU3 element `EligibilityResponse.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).

CoverageEligibilityResponse.disposition

disposition

is equivalent to

EligibilityResponse.disposition

Element `CoverageEligibilityResponse.disposition` is mapped to FHIR STU3 element `EligibilityResponse.disposition` as `Equivalent`.

CoverageEligibilityResponse.insurer

insurer

maps to wider concept

EligibilityResponse.insurer

Element `CoverageEligibilityResponse.insurer` is mapped to FHIR STU3 element `EligibilityResponse.insurer` as `SourceIsBroaderThanTarget`. The mappings for `CoverageEligibilityResponse.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 R5 element `CoverageEligibilityResponse.insurer` with unmapped reference targets: Organization.

CoverageEligibilityResponse.insurance

insurance

maps to wider concept

EligibilityResponse.insurance

Element `CoverageEligibilityResponse.insurance` is mapped to FHIR STU3 element `EligibilityResponse.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.

CoverageEligibilityResponse.insurance.coverage

coverage

maps to wider concept

EligibilityResponse.insurance.coverage

Element `CoverageEligibilityResponse.insurance.coverage` is mapped to FHIR STU3 element `EligibilityResponse.insurance.coverage` as `SourceIsBroaderThanTarget`. The mappings for `CoverageEligibilityResponse.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 R5 element `CoverageEligibilityResponse.insurance.coverage` with unmapped reference targets: Coverage.

CoverageEligibilityResponse.insurance.inforce

inforce

is equivalent to

EligibilityResponse.inforce

Element `CoverageEligibilityResponse.insurance.inforce` is mapped to FHIR STU3 element `EligibilityResponse.inforce` as `Equivalent`.

CoverageEligibilityResponse.insurance.item

item

maps to wider concept

EligibilityResponse.insurance.benefitBalance

Element `CoverageEligibilityResponse.insurance.item` is mapped to FHIR STU3 element `EligibilityResponse.insurance.benefitBalance` as `Equivalent`.

CoverageEligibilityResponse.insurance.item.category

category

is equivalent to

EligibilityResponse.insurance.benefitBalance.category

Element `CoverageEligibilityResponse.insurance.item.category` is mapped to FHIR STU3 element `EligibilityResponse.insurance.benefitBalance.category` as `Equivalent`. Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

CoverageEligibilityResponse.insurance.item.productOrService

productOrService

is equivalent to

EligibilityResponse.insurance.benefitBalance.subCategory

Element `CoverageEligibilityResponse.insurance.item.productOrService` is mapped to FHIR STU3 element `EligibilityResponse.insurance.benefitBalance.subCategory` as `Equivalent`. Code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI).

CoverageEligibilityResponse.insurance.item.excluded

excluded

is equivalent to

EligibilityResponse.insurance.benefitBalance.excluded

Element `CoverageEligibilityResponse.insurance.item.excluded` is mapped to FHIR STU3 element `EligibilityResponse.insurance.benefitBalance.excluded` as `Equivalent`.

CoverageEligibilityResponse.insurance.item.name

name

is equivalent to

EligibilityResponse.insurance.benefitBalance.name

Element `CoverageEligibilityResponse.insurance.item.name` is mapped to FHIR STU3 element `EligibilityResponse.insurance.benefitBalance.name` as `Equivalent`. For example: MED01, or DENT2.

CoverageEligibilityResponse.insurance.item.description

description

is equivalent to

EligibilityResponse.insurance.benefitBalance.description

Element `CoverageEligibilityResponse.insurance.item.description` is mapped to FHIR STU3 element `EligibilityResponse.insurance.benefitBalance.description` as `Equivalent`. For example 'DENT2 covers 100% of basic, 50% of major but excludes Ortho, Implants and Cosmetic services'.

CoverageEligibilityResponse.insurance.item.network

network

is equivalent to

EligibilityResponse.insurance.benefitBalance.network

Element `CoverageEligibilityResponse.insurance.item.network` is mapped to FHIR STU3 element `EligibilityResponse.insurance.benefitBalance.network` as `Equivalent`.

CoverageEligibilityResponse.insurance.item.unit

unit

is equivalent to

EligibilityResponse.insurance.benefitBalance.unit

Element `CoverageEligibilityResponse.insurance.item.unit` is mapped to FHIR STU3 element `EligibilityResponse.insurance.benefitBalance.unit` as `Equivalent`.

CoverageEligibilityResponse.insurance.item.term

term

is equivalent to

EligibilityResponse.insurance.benefitBalance.term

Element `CoverageEligibilityResponse.insurance.item.term` is mapped to FHIR STU3 element `EligibilityResponse.insurance.benefitBalance.term` as `Equivalent`.

CoverageEligibilityResponse.insurance.item.benefit

benefit

maps to wider concept

EligibilityResponse.insurance.benefitBalance.financial

Element `CoverageEligibilityResponse.insurance.item.benefit` is mapped to FHIR STU3 element `EligibilityResponse.insurance.benefitBalance.financial` as `Equivalent`.

CoverageEligibilityResponse.insurance.item.benefit.type

type

is equivalent to

EligibilityResponse.insurance.benefitBalance.financial.type

Element `CoverageEligibilityResponse.insurance.item.benefit.type` is mapped to FHIR STU3 element `EligibilityResponse.insurance.benefitBalance.financial.type` as `Equivalent`. For example: deductible, visits, benefit amount.

CoverageEligibilityResponse.insurance.item.benefit.allowed[x]

allowed[x]

is equivalent to

EligibilityResponse.insurance.benefitBalance.financial.allowed[x]

Element `CoverageEligibilityResponse.insurance.item.benefit.allowed[x]` is mapped to FHIR STU3 element `EligibilityResponse.insurance.benefitBalance.financial.allowed[x]` as `Equivalent`. The target context `EligibilityResponse.insurance.benefitBalance.financial.allowed[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `EligibilityResponse.insurance.benefitBalance.financial`.

CoverageEligibilityResponse.insurance.item.benefit.used[x]

used[x]

maps to wider concept

EligibilityResponse.insurance.benefitBalance.financial.used[x]

Element `CoverageEligibilityResponse.insurance.item.benefit.used[x]` is mapped to FHIR STU3 element `EligibilityResponse.insurance.benefitBalance.financial.used[x]` as `SourceIsBroaderThanTarget`. The mappings for `CoverageEligibilityResponse.insurance.item.benefit.used[x]` do not cover the following types: string. The target context `EligibilityResponse.insurance.benefitBalance.financial.used[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `EligibilityResponse.insurance.benefitBalance.financial`.

CoverageEligibilityResponse.form

form

is equivalent to

EligibilityResponse.form

Element `CoverageEligibilityResponse.form` is mapped to FHIR STU3 element `EligibilityResponse.form` as `Equivalent`. May be needed to identify specific jurisdictional forms.

CoverageEligibilityResponse.error

error

maps to wider concept

EligibilityResponse.error

Element `CoverageEligibilityResponse.error` is mapped to FHIR STU3 element `EligibilityResponse.error` as `Equivalent`.

CoverageEligibilityResponse.error.code

code

is equivalent to

EligibilityResponse.error.code

Element `CoverageEligibilityResponse.error.code` is mapped to FHIR STU3 element `EligibilityResponse.error.code` as `Equivalent`.

Group 2 Mapping from http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse|5.0.0 to R5: auth-requirements | benefits | discovery | validation (new)version: 0.1.0)

Source Code

Relationship

Target Code

Comment

CoverageEligibilityResponse.purpose (purpose)

is equivalent to

Extension (R5: auth-requirements | benefits | discovery | validation (new))

Element `CoverageEligibilityResponse.purpose` has a context of EligibilityResponse based on following the parent source element upwards and mapping to `EligibilityResponse`. Element `CoverageEligibilityResponse.purpose` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

Group 3 Mapping from http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse|5.0.0 to R5: Intended recipient of products and services (new)version: 0.1.0)

Source Code

Relationship

Target Code

Comment

CoverageEligibilityResponse.patient (patient)

is equivalent to

Extension (R5: Intended recipient of products and services (new))

Element `CoverageEligibilityResponse.patient` has a context of EligibilityResponse based on following the parent source element upwards and mapping to `EligibilityResponse`. Element `CoverageEligibilityResponse.patient` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

Group 4 Mapping from http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse|5.0.0 to R5: Event information (new)version: 0.1.0)

Source Code

Relationship

Target Code

Comment

CoverageEligibilityResponse.event (event)

maps to wider concept

Extension (R5: Event information (new))

Element `CoverageEligibilityResponse.event` has a context of EligibilityResponse based on following the parent source element upwards and mapping to `EligibilityResponse`. Element `CoverageEligibilityResponse.event` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

CoverageEligibilityResponse.event.type (type)

maps to wider concept

Extension.extension:type (R5: Specific event (new))

Element `CoverageEligibilityResponse.event.type` is part of an existing definition because parent element `CoverageEligibilityResponse.event` requires a cross-version extension. Element `CoverageEligibilityResponse.event.type` has a context of EligibilityResponse based on following the parent source element upwards and mapping to `EligibilityResponse`. Element `CoverageEligibilityResponse.event.type` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

CoverageEligibilityResponse.event.when[x] (when[x])

maps to wider concept

Extension.extension:when (R5: Occurance date or period (new))

Element `CoverageEligibilityResponse.event.when[x]` is part of an existing definition because parent element `CoverageEligibilityResponse.event` requires a cross-version extension. Element `CoverageEligibilityResponse.event.when[x]` has a context of EligibilityResponse based on following the parent source element upwards and mapping to `EligibilityResponse`. Element `CoverageEligibilityResponse.event.when[x]` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

Group 5 Mapping from http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse|5.0.0 to R5: Estimated date or dates of service (new)version: 0.1.0)

Source Code

Relationship

Target Code

Comment

CoverageEligibilityResponse.serviced[x] (serviced[x])

is equivalent to

Extension (R5: Estimated date or dates of service (new))

Element `CoverageEligibilityResponse.serviced[x]` has a context of EligibilityResponse based on following the parent source element upwards and mapping to `EligibilityResponse`. Element `CoverageEligibilityResponse.serviced[x]` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

Group 6 Mapping from http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse|5.0.0 to R5: queued | complete | error | partialversion: 0.1.0)

Source Code

Relationship

Target Code

Comment

CoverageEligibilityResponse.outcome (outcome)

maps to wider concept

Extension (R5: queued | complete | error | partial)

Group 7 Mapping from http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse|5.0.0 to R5: When the benefits are applicable (new)version: 0.1.0)

Source Code

Relationship

Target Code

Comment

CoverageEligibilityResponse.insurance.benefitPeriod (benefitPeriod)

is equivalent to

Extension (R5: When the benefits are applicable (new))

Element `CoverageEligibilityResponse.insurance.benefitPeriod` has a context of EligibilityResponse.insurance based on following the parent source element upwards and mapping to `EligibilityResponse`. Element `CoverageEligibilityResponse.insurance.benefitPeriod` 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/CoverageEligibilityResponse|5.0.0 to R5: Product or service billing modifiers (new)version: 0.1.0)

Source Code

Relationship

Target Code

Comment

CoverageEligibilityResponse.insurance.item.modifier (modifier)

is equivalent to

Extension (R5: Product or service billing modifiers (new))

Element `CoverageEligibilityResponse.insurance.item.modifier` has a context of EligibilityResponse.insurance.benefitBalance based on following the parent source element upwards and mapping to `EligibilityResponse`. Element `CoverageEligibilityResponse.insurance.item.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.

Group 9 Mapping from http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse|5.0.0 to R5: Performing practitioner (new)version: 0.1.0)

Source Code

Relationship

Target Code

Comment

CoverageEligibilityResponse.insurance.item.provider (provider)

is equivalent to

Extension (R5: Performing practitioner (new))

Element `CoverageEligibilityResponse.insurance.item.provider` has a context of EligibilityResponse.insurance.benefitBalance based on following the parent source element upwards and mapping to `EligibilityResponse`. Element `CoverageEligibilityResponse.insurance.item.provider` 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/CoverageEligibilityResponse|5.0.0 to R5: used additional typesversion: 0.1.0)

Source Code

Relationship

Target Code

Comment

CoverageEligibilityResponse.insurance.item.benefit.used[x] (used[x])

maps to wider concept

Extension (R5: used additional types)

Group 11 Mapping from http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse|5.0.0 to R5: Authorization required flag (new)version: 0.1.0)

Source Code

Relationship

Target Code

Comment

CoverageEligibilityResponse.insurance.item.authorizationRequired (authorizationRequired)

is equivalent to

Extension (R5: Authorization required flag (new))

Element `CoverageEligibilityResponse.insurance.item.authorizationRequired` has a context of EligibilityResponse.insurance.benefitBalance based on following the parent source element upwards and mapping to `EligibilityResponse`. Element `CoverageEligibilityResponse.insurance.item.authorizationRequired` 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/CoverageEligibilityResponse|5.0.0 to R5: Type of required supporting materials (new)version: 0.1.0)

Source Code

Relationship

Target Code

Comment

CoverageEligibilityResponse.insurance.item.authorizationSupporting (authorizationSupporting)

is equivalent to

Extension (R5: Type of required supporting materials (new))

Element `CoverageEligibilityResponse.insurance.item.authorizationSupporting` has a context of EligibilityResponse.insurance.benefitBalance based on following the parent source element upwards and mapping to `EligibilityResponse`. Element `CoverageEligibilityResponse.insurance.item.authorizationSupporting` 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/CoverageEligibilityResponse|5.0.0 to R5: Preauthorization requirements endpoint (new)version: 0.1.0)

Source Code

Relationship

Target Code

Comment

CoverageEligibilityResponse.insurance.item.authorizationUrl (authorizationUrl)

is equivalent to

Extension (R5: Preauthorization requirements endpoint (new))

Element `CoverageEligibilityResponse.insurance.item.authorizationUrl` has a context of EligibilityResponse.insurance.benefitBalance based on following the parent source element upwards and mapping to `EligibilityResponse`. Element `CoverageEligibilityResponse.insurance.item.authorizationUrl` 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/CoverageEligibilityResponse|5.0.0 to R5: Preauthorization reference (new)version: 0.1.0)

Source Code

Relationship

Target Code

Comment

CoverageEligibilityResponse.preAuthRef (preAuthRef)

is equivalent to

Extension (R5: Preauthorization reference (new))

Element `CoverageEligibilityResponse.preAuthRef` has a context of EligibilityResponse based on following the parent source element upwards and mapping to `EligibilityResponse`. Element `CoverageEligibilityResponse.preAuthRef` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

Group 15 Mapping from http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse|5.0.0 to R5: FHIRPath of element(s) related to issue (new)version: 0.1.0)

Source Code

Relationship

Target Code

Comment

CoverageEligibilityResponse.error.expression (expression)

maps to wider concept

Extension (R5: FHIRPath of element(s) related to issue (new))

Element `CoverageEligibilityResponse.error.expression` has a context of EligibilityResponse.error based on following the parent source element upwards and mapping to `EligibilityResponse`. Element `CoverageEligibilityResponse.error.expression` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The root of the FHIRPath is the resource or bundle that generated OperationOutcome. Each FHIRPath SHALL resolve to a single node.