The ChargeItemDefinition resource provides the properties that apply to the (billing) codes necessary to calculate costs and prices. The properties may differ largely depending on type and realm, therefore this resource gives only a rough structure and requires profiling for each type of billing code system.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

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.

An Extension

R5: ChargeItemDefinition.versionAlgorithm[x] (new:Coding, string)

Element ChargeItemDefinition.versionAlgorithm[x] has a context of ChargeItemDefinition based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.versionAlgorithm[x] has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

R5: ChargeItemDefinition.name (new:string)

Element ChargeItemDefinition.name has a context of ChargeItemDefinition based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.name has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

R5: ChargeItemDefinition.purpose (new:markdown)

Element ChargeItemDefinition.purpose has a context of ChargeItemDefinition based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.purpose has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). This element does not describe the usage of the charge item definition. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this charge item definition.

R5: ChargeItemDefinition.copyrightLabel (new:string)

Element ChargeItemDefinition.copyrightLabel has a context of ChargeItemDefinition based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.copyrightLabel has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

An absolute URI that is used to identify this charge item definition when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this charge item definition is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the charge item definition is stored on different servers.

Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

Allows the charge item definition to be referenced by a single globally unique identifier.

The current state of the ChargeItemDefinition.

Allows filtering of charge item definitions that are appropriate for use versus not.

The lifecycle status of an artifact.

R5: ChargeItemDefinition.versionAlgorithm[x] (new:Coding, string)

Element ChargeItemDefinition.versionAlgorithm[x] has a context of ChargeItemDefinition based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.versionAlgorithm[x] has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

R5: ChargeItemDefinition.name (new:string)

Element ChargeItemDefinition.name has a context of ChargeItemDefinition based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.name has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

R5: ChargeItemDefinition.purpose (new:markdown)

Element ChargeItemDefinition.purpose has a context of ChargeItemDefinition based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.purpose has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). This element does not describe the usage of the charge item definition. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this charge item definition.

R5: ChargeItemDefinition.copyrightLabel (new:string)

Element ChargeItemDefinition.copyrightLabel has a context of ChargeItemDefinition based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.copyrightLabel has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

R5: ChargeItemDefinition.instance

Element ChargeItemDefinition.instance is mapped to FHIR R4 element ChargeItemDefinition.instance as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element ChargeItemDefinition.instance with unmapped reference targets: ActivityDefinition, DeviceDefinition, HealthcareService, PlanDefinition. In case of highly customized, individually produced or fitted devices/substances, the pricing information may be different for each instance of the product. This reference links pricing details to specific product instances.

R5: ChargeItemDefinition.applicability.condition (new:Expression)

Element ChargeItemDefinition.applicability.condition has a context of ChargeItemDefinition.applicability based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.applicability.condition has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). Please note that FHIRPath Expressions can only be evaluated in the scope of the current ChargeItem resource to which this definition is being applied. FHIRPath expressions can traverse into other resources linked from the ChargeItem resource, however, testing rules such as that a billing code may be billed only once per encounter need a wider scope. In such scenarios, CQL may be the appropriate choice.

R5: ChargeItemDefinition.applicability.effectivePeriod (new:Period)

Element ChargeItemDefinition.applicability.effectivePeriod has a context of ChargeItemDefinition.applicability based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.applicability.effectivePeriod has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). The effective period for a charge item definition determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

R5: ChargeItemDefinition.applicability.relatedArtifact (new:RelatedArtifact)

Element ChargeItemDefinition.applicability.relatedArtifact has a context of ChargeItemDefinition.applicability based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.applicability.relatedArtifact has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

The ChargeItemDefinition resource provides the properties that apply to the (billing) codes necessary to calculate costs and prices. The properties may differ largely depending on type and realm, therefore this resource gives only a rough structure and requires profiling for each type of billing code system.

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

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.

The base language in which the resource is written.

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).

The codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

A human language.

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

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.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

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.

An Extension

R5: ChargeItemDefinition.versionAlgorithm[x] (new:Coding, string)

Element ChargeItemDefinition.versionAlgorithm[x] has a context of ChargeItemDefinition based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.versionAlgorithm[x] has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

R5: ChargeItemDefinition.name (new:string)

Element ChargeItemDefinition.name has a context of ChargeItemDefinition based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.name has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

R5: ChargeItemDefinition.purpose (new:markdown)

Element ChargeItemDefinition.purpose has a context of ChargeItemDefinition based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.purpose has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). This element does not describe the usage of the charge item definition. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this charge item definition.

R5: ChargeItemDefinition.copyrightLabel (new:string)

Element ChargeItemDefinition.copyrightLabel has a context of ChargeItemDefinition based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.copyrightLabel has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

An absolute URI that is used to identify this charge item definition when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this charge item definition is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the charge item definition is stored on different servers.

Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

Allows the charge item definition to be referenced by a single globally unique identifier.

A formal identifier that is used to identify this charge item definition when it is represented in other formats, or referenced in a specification, model, design or an instance.

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this charge item definition outside of FHIR, where it is not possible to use the logical URI.

Allows externally provided and/or usable business identifiers to be easily associated with the module.

The identifier that is used to identify this version of the charge item definition when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the charge item definition author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active assets.

There may be different charge item definition instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the charge item definition with the format [url]|[version].

A short, descriptive, user-friendly title for the charge item definition.

This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

The URL pointing to an externally-defined charge item definition that is adhered to in whole or in part by this definition.

A larger definition of which this particular definition is a component or step.

As new versions of a protocol or guideline are defined, allows identification of what versions are replaced by a new instance.

The current state of the ChargeItemDefinition.

Allows filtering of charge item definitions that are appropriate for use versus not.

The lifecycle status of an artifact.

A Boolean value to indicate that this charge item definition is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

Allows filtering of charge item definitions that are appropriate for use versus not.

Enables experimental content to be developed following the same lifecycle that would be used for a production-level charge item definition.

The date (and optionally time) when the charge item definition was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the charge item definition changes.

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the charge item definition. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

The name of the organization or individual that published the charge item definition.

Usually an organization but may be an individual. The publisher (or steward) of the charge item definition is the organization or individual primarily responsible for the maintenance and upkeep of the charge item definition. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the charge item definition. This item SHOULD be populated unless the information is available from context.

Helps establish the "authority/credibility" of the charge item definition. May also allow for contact.

Contact details to assist a user in finding and communicating with the publisher.

May be a web site, an email address, a telephone number, etc.

A free text natural language description of the charge item definition from a consumer's perspective.

This description can be used to capture details such as why the charge item definition was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the charge item definition as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the charge item definition is presumed to be the predominant language in the place the charge item definition was created).

The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate charge item definition instances.

When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

Assist in searching for appropriate content.

A legal or geographic region in which the charge item definition is intended to be used.

It may be possible for the charge item definition to be used in jurisdictions other than those for which it was originally designed or intended.

Countries and regions within which this artifact is targeted for use.

A copyright statement relating to the charge item definition and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the charge item definition.

Consumers must be able to determine any legal restrictions on the use of the charge item definition and/or its content.

The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

If specified, this date follows the original approval date.

Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

The period during which the charge item definition content was or is planned to be in active use.

The effective period for a charge item definition determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the charge item definition are or are expected to be used instead.

The defined billing details in this resource pertain to the given billing code.

Billing Code defined by this ChargeItemDefinition.

The defined billing details in this resource pertain to the given product instance(s).

In case of highly customized, individually produced or fitted devices/substances, the pricing information may be different for each instance of the product. This reference links pricing details to specific product instances.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

R5: ChargeItemDefinition.instance

Element ChargeItemDefinition.instance is mapped to FHIR R4 element ChargeItemDefinition.instance as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element ChargeItemDefinition.instance with unmapped reference targets: ActivityDefinition, DeviceDefinition, HealthcareService, PlanDefinition. In case of highly customized, individually produced or fitted devices/substances, the pricing information may be different for each instance of the product. This reference links pricing details to specific product instances.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Unless not suitable, these codes SHALL be taken from ResourceType
(extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)

Aa resource (or, for logical models, the URI of the logical model).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Expressions that describe applicability criteria for the billing code.

The applicability conditions can be used to ascertain whether a billing item is allowed in a specific context. E.g. some billing codes may only be applicable in out-patient settings, only to male/female patients or only to children.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

R5: ChargeItemDefinition.applicability.condition (new:Expression)

Element ChargeItemDefinition.applicability.condition has a context of ChargeItemDefinition.applicability based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.applicability.condition has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). Please note that FHIRPath Expressions can only be evaluated in the scope of the current ChargeItem resource to which this definition is being applied. FHIRPath expressions can traverse into other resources linked from the ChargeItem resource, however, testing rules such as that a billing code may be billed only once per encounter need a wider scope. In such scenarios, CQL may be the appropriate choice.

R5: ChargeItemDefinition.applicability.effectivePeriod (new:Period)

Element ChargeItemDefinition.applicability.effectivePeriod has a context of ChargeItemDefinition.applicability based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.applicability.effectivePeriod has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). The effective period for a charge item definition determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

R5: ChargeItemDefinition.applicability.relatedArtifact (new:RelatedArtifact)

Element ChargeItemDefinition.applicability.relatedArtifact has a context of ChargeItemDefinition.applicability based on following the parent source element upwards and mapping to ChargeItemDefinition. Element ChargeItemDefinition.applicability.relatedArtifact has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

A brief, natural language description of the condition that effectively communicates the intended semantics.

The media type of the language for the expression, e.g. "text/cql" for Clinical Query Language expressions or "text/fhirpath" for FHIRPath expressions.

An expression that returns true or false, indicating whether the condition is satisfied. When using FHIRPath expressions, the %context environment variable must be replaced at runtime with the ChargeItem resource to which this definition is applied.

Please note that FHIRPath Expressions can only be evaluated in the scope of the current ChargeItem resource to which this definition is being applied. FHIRPath expressions can traverse into other resources linked from the ChargeItem resource, however, testing rules such as that a billing code may be billed only once per encounter need a wider scope. In such scenarios, CQL may be the appropriate choice.

Group of properties which are applicable under the same conditions. If no applicability rules are established for the group, then all properties always apply.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. 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 can 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.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Expressions that describe applicability criteria for the priceComponent.

The applicability conditions can be used to ascertain whether a billing item is allowed in a specific context. E.g. some billing codes may only be applicable in out-patient settings, only to male/female patients or only to children.

The price for a ChargeItem may be calculated as a base price with surcharges/deductions that apply in certain conditions. A ChargeItemDefinition resource that defines the prices, factors and conditions that apply to a billing code is currently under development. The priceComponent element can be used to offer transparency to the recipient of the Invoice of how the prices have been calculated.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. 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 can 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.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

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.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

This code identifies the type of the component.

Codes indicating the kind of the price component.

A code that identifies the component. Codes may be used to differentiate between kinds of taxes, surcharges, discounts etc.

The factor that has been applied on the base price for calculating this component.

The amount calculated for this component.