This page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

8.27 Resource ChargeItem - Content

Patient Administration icon

Work Group

Maturity Level: 1

Trial Use

Security Category: Patient

Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson

The resource ChargeItem describes the provision of healthcare provider products for a certain patient, therefore referring not only to the product, but containing in addition details of the provision, like date, time, amounts and participating organizations and persons. Main Usage of the ChargeItem is to enable the billing process and internal cost allocation.

8.27.1 Scope and Usage

Tracking Financial information is vital in Patient Administration and Finance systems in most Healthcare Organizations. The resource ChargeItem describes the charge for provision of healthcare provider products for a certain patient, therefore referring not only to the product, but containing in addition details of the provision, like date, time, amounts and participating organizations and persons. Main Usage of the ChargeItem is to enable the billing process and internal cost allocation. They are created as soon as the products are planned or provisioned, references to Encounters and/or Accounts can be maintained in a later process step.

The target of ChargeItem.definition may provide information on the Charge code such as pricing and inclusion/exclusion rules as well as factors that apply under certain conditions. In many cases however this information may have been drawn from sources outside of FHIR depending on the distribution format of the code catalogue. The ChargeItem assumes that such information is either implicitly known by the communicating systems or explicitly shared through the ChargeItem.definition. Therefore explicit pricing information is not shared within the ChargeItem resource. Also, the systems posting the ChargeItems are not expected to apply the rules associated with the charge codes as they may not know the whole context of the patient/encounter to evaluate such rules. It lies within the responsibility of a billing engine, to collect the ChargeItems in the context of an Account or Encounter at a certain point in time (e.g. discharge of the patient) and to evaluate the associated rules resulting in some of the ChargeItems to be set to the status "not billable" in case the rules exclude them from being billed, or to create financial transactions according to base price and factors. Additional references to Encounter/EpisodeOfCare, Patient/Group and Services provide further context to help billing systems determine the appropriate account and establish the clinical/financial context to evaluate the rules associated with the charge codes.

8.27.2 Boundaries and Relationships

This resource is not an actual financial transaction (such as an item on an invoice or any concise monetary amount being transferred from one Account to another) but is the base administrative data that may be used by a billing engine to create the financial transactions based on rules, factors and base prices associated with the charge code.

Unlike the Financial Transaction the ChargeItem primarily describes the provision, whereas the Financial Transaction documents cash flow. Therefore, the Financial Transaction results from ChargeItems created via the subsequent billing- or cost allocation process.

The actual financial transaction resulting from the evaluation of these rules against the clinical and financial context may be represented in formats appropriate to the financial realm. These are considered out of scope for the FHIR Standard, as they are not specific to the healthcare domain. The FHIR Claim resource does contain line items, and this ChargeItem resource provides the source material for the billing engine to create the items on the claim (which may be different due to business rules).

8.27.3 References to this Resource

Implements: Event
Resource References: itself, Invoice and PaymentReconciliation

Structure

Name	Flags	Card.	Type	Description & Constraints
ChargeItem	TU		DomainResource	Item containing charge code(s) associated with the provision of healthcare provider products Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	Business Identifier for item
definitionUri		0..*	uri	Defining information about the code of this charge item
definitionCanonical		0..*	canonical(ChargeItemDefinition)	Resource defining the code of this ChargeItem
status	?!Σ	1..1	code	planned \| billable \| not-billable \| aborted \| billed \| entered-in-error \| unknown Binding: Charge Item Status (Required)
partOf		0..*	Reference(ChargeItem)	Part of referenced ChargeItem
code	Σ	1..1	CodeableConcept	A code that identifies the charge, like a billing code Binding: Charge Item Code (Example)
subject	Σ	1..1	Reference(Patient \| Group)	Individual service was done for/to
encounter	Σ	0..1	Reference(Encounter)	Encounter associated with this ChargeItem
occurrence[x]	Σ	0..1		When the charged service was applied
occurrenceDateTime			dateTime
occurrencePeriod			Period
occurrenceTiming			Timing
performer		0..*	BackboneElement	Who performed charged service
function		0..1	CodeableConcept	What type of performance was done Binding: Procedure Performer Role Codes (Example)
actor		1..1	Reference(Practitioner \| PractitionerRole \| Organization \| HealthcareService \| CareTeam \| Patient \| Device \| RelatedPerson)	Individual who was performing
performingOrganization		0..1	Reference(Organization)	Organization providing the charged service
requestingOrganization		0..1	Reference(Organization)	Organization requesting the charged service
costCenter		0..1	Reference(Organization)	Organization that has ownership of the (potential, future) revenue
quantity	Σ	0..1	Quantity	Quantity of which the charge item has been serviced
bodysite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMED CT Body Structures (Example)
unitPriceComponent		0..1	MonetaryComponent	Unit price overriding the associated rules
totalPriceComponent		0..1	MonetaryComponent	Total price overriding the associated rules
overrideReason		0..1	CodeableConcept	Reason for overriding the list price/factor Binding: override-reason (Example)
enterer	Σ	0..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| Device \| RelatedPerson)	Individual who was entering
enteredDate	Σ	0..1	dateTime	Date the charge item was entered
reason		0..*	CodeableConcept	Why was the charged service rendered? Binding: ICD-10 Codes (Example)
service		0..*	CodeableReference(DiagnosticReport \| ImagingStudy \| Immunization \| MedicationAdministration \| MedicationDispense \| MedicationRequest \| Observation \| Procedure \| ServiceRequest \| SupplyDelivery)	Which rendered service is being charged?
product		0..*	CodeableReference(Device \| Medication \| Substance)	Product charged Binding: Device Type (Example)
account	Σ	0..*	Reference(Account)	Account to place this charge
note		0..*	Annotation	Comments made about the ChargeItem
supportingInformation		0..*	Reference(Any)	Further information supporting this charge
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<ChargeItem xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifier for item --></identifier>
 <definitionUri value="[uri]"/><!-- 0..* Defining information about the code of this charge item -->
 <definitionCanonical><!-- 0..* canonical(ChargeItemDefinition) Resource defining the code of this ChargeItem --></definitionCanonical>
 <status value="[code]"/><!-- 1..1 planned | billable | not-billable | aborted | billed | entered-in-error | unknown -->
 <partOf><!-- 0..* Reference(ChargeItem) Part of referenced ChargeItem --></partOf>
 <code><!-- 1..1 CodeableConcept A code that identifies the charge, like a billing code --></code>
 <subject><!-- 1..1 Reference(Group|Patient) Individual service was done for/to --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter associated with this ChargeItem --></encounter>
 <occurrence[x]><!-- 0..1 dateTime|Period|Timing When the charged service was applied --></occurrence[x]>
 <performer>  <!-- 0..* Who performed charged service -->
  <function><!-- 0..1 CodeableConcept What type of performance was done --></function>
  <actor><!-- 1..1 Reference(CareTeam|Device|HealthcareService|Organization|
    Patient|Practitioner|PractitionerRole|RelatedPerson) Individual who was performing --></actor>
 </performer>
 <performingOrganization><!-- 0..1 Reference(Organization) Organization providing the charged service --></performingOrganization>
 <requestingOrganization><!-- 0..1 Reference(Organization) Organization requesting the charged service --></requestingOrganization>
 <costCenter><!-- 0..1 Reference(Organization) Organization that has ownership of the (potential, future) revenue --></costCenter>
 <quantity><!-- 0..1 Quantity Quantity of which the charge item has been serviced --></quantity>
 <bodysite><!-- 0..* CodeableConcept Anatomical location, if relevant --></bodysite>
 <unitPriceComponent><!-- 0..1 MonetaryComponent Unit price overriding the associated rules --></unitPriceComponent>
 <totalPriceComponent><!-- 0..1 MonetaryComponent Total price overriding the associated rules --></totalPriceComponent>
 <overrideReason><!-- 0..1 CodeableConcept Reason for overriding the list price/factor --></overrideReason>
 <enterer><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Individual who was entering --></enterer>
 <enteredDate value="[dateTime]"/><!-- 0..1 Date the charge item was entered -->
 <reason><!-- 0..* CodeableConcept Why was the charged  service rendered? --></reason>
 <service><!-- 0..* CodeableReference(DiagnosticReport|ImagingStudy|Immunization|
   MedicationAdministration|MedicationDispense|MedicationRequest|Observation|
   Procedure|ServiceRequest|SupplyDelivery) Which rendered service is being charged? --></service>
 <product><!-- 0..* CodeableReference(Device|Medication|Substance) Product charged --></product>
 <account><!-- 0..* Reference(Account) Account to place this charge --></account>
 <note><!-- 0..* Annotation Comments made about the ChargeItem --></note>
 <supportingInformation><!-- 0..* Reference(Any) Further information supporting this charge --></supportingInformation>
</ChargeItem>

JSON Template

{
  "resourceType" : "ChargeItem",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier for item
  "definitionUri" : ["<uri>"], // Defining information about the code of this charge item
  "definitionCanonical" : ["<canonical(ChargeItemDefinition)>"], // Resource defining the code of this ChargeItem
  "status" : "<code>", // R!  planned | billable | not-billable | aborted | billed | entered-in-error | unknown
  "partOf" : [{ Reference(ChargeItem) }], // Part of referenced ChargeItem
  "code" : { CodeableConcept }, // R!  A code that identifies the charge, like a billing code
  "subject" : { Reference(Group|Patient) }, // R!  Individual service was done for/to
  "encounter" : { Reference(Encounter) }, // Encounter associated with this ChargeItem
  // occurrence[x]: When the charged service was applied. One of these 3:
  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "occurrenceTiming" : { Timing },
  "performer" : [{ // Who performed charged service
    "function" : { CodeableConcept }, // What type of performance was done
    "actor" : { Reference(CareTeam|Device|HealthcareService|Organization|
    Patient|Practitioner|PractitionerRole|RelatedPerson) } // R!  Individual who was performing
  }],
  "performingOrganization" : { Reference(Organization) }, // Organization providing the charged service
  "requestingOrganization" : { Reference(Organization) }, // Organization requesting the charged service
  "costCenter" : { Reference(Organization) }, // Organization that has ownership of the (potential, future) revenue
  "quantity" : { Quantity }, // Quantity of which the charge item has been serviced
  "bodysite" : [{ CodeableConcept }], // Anatomical location, if relevant
  "unitPriceComponent" : { MonetaryComponent }, // Unit price overriding the associated rules
  "totalPriceComponent" : { MonetaryComponent }, // Total price overriding the associated rules
  "overrideReason" : { CodeableConcept }, // Reason for overriding the list price/factor
  "enterer" : { Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Individual who was entering
  "enteredDate" : "<dateTime>", // Date the charge item was entered
  "reason" : [{ CodeableConcept }], // Why was the charged  service rendered?
  "service" : [{ CodeableReference(DiagnosticReport|ImagingStudy|Immunization|
   MedicationAdministration|MedicationDispense|MedicationRequest|Observation|
   Procedure|ServiceRequest|SupplyDelivery) }], // Which rendered service is being charged?
  "product" : [{ CodeableReference(Device|Medication|Substance) }], // Product charged
  "account" : [{ Reference(Account) }], // Account to place this charge
  "note" : [{ Annotation }], // Comments made about the ChargeItem
  "supportingInformation" : [{ Reference(Any) }] // Further information supporting this charge
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:ChargeItem;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business Identifier for item
  fhir:definitionUri  ( [ uri ] ... ) ; # 0..* Defining information about the code of this charge item
  fhir:definitionCanonical  ( [ canonical(ChargeItemDefinition) ] ... ) ; # 0..* Resource defining the code of this ChargeItem
  fhir:status [ code ] ; # 1..1 planned | billable | not-billable | aborted | billed | entered-in-error | unknown
  fhir:partOf  ( [ Reference(ChargeItem) ] ... ) ; # 0..* Part of referenced ChargeItem
  fhir:code [ CodeableConcept ] ; # 1..1 A code that identifies the charge, like a billing code
  fhir:subject [ Reference(Group|Patient) ] ; # 1..1 Individual service was done for/to
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 Encounter associated with this ChargeItem
  # occurrence[x] : 0..1 When the charged service was applied. One of these 3
    fhir:occurrence [  a fhir:dateTime ; dateTime ]
    fhir:occurrence [  a fhir:Period ; Period ]
    fhir:occurrence [  a fhir:Timing ; Timing ]
  fhir:performer ( [ # 0..* Who performed charged service
    fhir:function [ CodeableConcept ] ; # 0..1 What type of performance was done
    fhir:actor [ Reference(CareTeam|Device|HealthcareService|Organization|Patient|Practitioner|
  PractitionerRole|RelatedPerson) ] ; # 1..1 Individual who was performing
  ] ... ) ;
  fhir:performingOrganization [ Reference(Organization) ] ; # 0..1 Organization providing the charged service
  fhir:requestingOrganization [ Reference(Organization) ] ; # 0..1 Organization requesting the charged service
  fhir:costCenter [ Reference(Organization) ] ; # 0..1 Organization that has ownership of the (potential, future) revenue
  fhir:quantity [ Quantity ] ; # 0..1 Quantity of which the charge item has been serviced
  fhir:bodysite  ( [ CodeableConcept ] ... ) ; # 0..* Anatomical location, if relevant
  fhir:unitPriceComponent [ MonetaryComponent ] ; # 0..1 Unit price overriding the associated rules
  fhir:totalPriceComponent [ MonetaryComponent ] ; # 0..1 Total price overriding the associated rules
  fhir:overrideReason [ CodeableConcept ] ; # 0..1 Reason for overriding the list price/factor
  fhir:enterer [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Individual who was entering
  fhir:enteredDate [ dateTime ] ; # 0..1 Date the charge item was entered
  fhir:reason  ( [ CodeableConcept ] ... ) ; # 0..* Why was the charged  service rendered?
  fhir:service  ( [ CodeableReference(DiagnosticReport|ImagingStudy|Immunization|MedicationAdministration|
  MedicationDispense|MedicationRequest|Observation|Procedure|ServiceRequest|
  SupplyDelivery) ] ... ) ; # 0..* Which rendered service is being charged?
  fhir:product  ( [ CodeableReference(Device|Medication|Substance) ] ... ) ; # 0..* Product charged
  fhir:account  ( [ Reference(Account) ] ... ) ; # 0..* Account to place this charge
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Comments made about the ChargeItem
  fhir:supportingInformation  ( [ Reference(Any) ] ... ) ; # 0..* Further information supporting this charge
]

Changes from both R4 and R4B

ChargeItem

ChargeItem.encounter

Added Element

ChargeItem.performer.actor

Type Reference: Added Target Type HealthcareService

ChargeItem.unitPriceComponent

Added Element

ChargeItem.totalPriceComponent

Added Element

ChargeItem.overrideReason

Type changed from string to CodeableConcept

ChargeItem.service

Type changed from Reference(DiagnosticReport | ImagingStudy | Immunization | MedicationAdministration | MedicationDispense | Observation | Procedure | SupplyDelivery) to CodeableReference

ChargeItem.product

Renamed from product[x] to product
Max Cardinality changed from 1 to *
Add Type CodeableReference
Remove Types Reference(Device | Medication | Substance), CodeableConcept

ChargeItem.context

Deleted

ChargeItem.factorOverride

Deleted

ChargeItem.priceOverride

Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)

Structure

Name	Flags	Card.	Type	Description & Constraints
ChargeItem	TU		DomainResource	Item containing charge code(s) associated with the provision of healthcare provider products Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	Business Identifier for item
definitionUri		0..*	uri	Defining information about the code of this charge item
definitionCanonical		0..*	canonical(ChargeItemDefinition)	Resource defining the code of this ChargeItem
status	?!Σ	1..1	code	planned \| billable \| not-billable \| aborted \| billed \| entered-in-error \| unknown Binding: Charge Item Status (Required)
partOf		0..*	Reference(ChargeItem)	Part of referenced ChargeItem
code	Σ	1..1	CodeableConcept	A code that identifies the charge, like a billing code Binding: Charge Item Code (Example)
subject	Σ	1..1	Reference(Patient \| Group)	Individual service was done for/to
encounter	Σ	0..1	Reference(Encounter)	Encounter associated with this ChargeItem
occurrence[x]	Σ	0..1		When the charged service was applied
occurrenceDateTime			dateTime
occurrencePeriod			Period
occurrenceTiming			Timing
performer		0..*	BackboneElement	Who performed charged service
function		0..1	CodeableConcept	What type of performance was done Binding: Procedure Performer Role Codes (Example)
actor		1..1	Reference(Practitioner \| PractitionerRole \| Organization \| HealthcareService \| CareTeam \| Patient \| Device \| RelatedPerson)	Individual who was performing
performingOrganization		0..1	Reference(Organization)	Organization providing the charged service
requestingOrganization		0..1	Reference(Organization)	Organization requesting the charged service
costCenter		0..1	Reference(Organization)	Organization that has ownership of the (potential, future) revenue
quantity	Σ	0..1	Quantity	Quantity of which the charge item has been serviced
bodysite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: SNOMED CT Body Structures (Example)
unitPriceComponent		0..1	MonetaryComponent	Unit price overriding the associated rules
totalPriceComponent		0..1	MonetaryComponent	Total price overriding the associated rules
overrideReason		0..1	CodeableConcept	Reason for overriding the list price/factor Binding: override-reason (Example)
enterer	Σ	0..1	Reference(Practitioner \| PractitionerRole \| Organization \| Patient \| Device \| RelatedPerson)	Individual who was entering
enteredDate	Σ	0..1	dateTime	Date the charge item was entered
reason		0..*	CodeableConcept	Why was the charged service rendered? Binding: ICD-10 Codes (Example)
service		0..*	CodeableReference(DiagnosticReport \| ImagingStudy \| Immunization \| MedicationAdministration \| MedicationDispense \| MedicationRequest \| Observation \| Procedure \| ServiceRequest \| SupplyDelivery)	Which rendered service is being charged?
product		0..*	CodeableReference(Device \| Medication \| Substance)	Product charged Binding: Device Type (Example)
account	Σ	0..*	Reference(Account)	Account to place this charge
note		0..*	Annotation	Comments made about the ChargeItem
supportingInformation		0..*	Reference(Any)	Further information supporting this charge
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<ChargeItem xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifier for item --></identifier>
 <definitionUri value="[uri]"/><!-- 0..* Defining information about the code of this charge item -->
 <definitionCanonical><!-- 0..* canonical(ChargeItemDefinition) Resource defining the code of this ChargeItem --></definitionCanonical>
 <status value="[code]"/><!-- 1..1 planned | billable | not-billable | aborted | billed | entered-in-error | unknown -->
 <partOf><!-- 0..* Reference(ChargeItem) Part of referenced ChargeItem --></partOf>
 <code><!-- 1..1 CodeableConcept A code that identifies the charge, like a billing code --></code>
 <subject><!-- 1..1 Reference(Group|Patient) Individual service was done for/to --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter associated with this ChargeItem --></encounter>
 <occurrence[x]><!-- 0..1 dateTime|Period|Timing When the charged service was applied --></occurrence[x]>
 <performer>  <!-- 0..* Who performed charged service -->
  <function><!-- 0..1 CodeableConcept What type of performance was done --></function>
  <actor><!-- 1..1 Reference(CareTeam|Device|HealthcareService|Organization|
    Patient|Practitioner|PractitionerRole|RelatedPerson) Individual who was performing --></actor>
 </performer>
 <performingOrganization><!-- 0..1 Reference(Organization) Organization providing the charged service --></performingOrganization>
 <requestingOrganization><!-- 0..1 Reference(Organization) Organization requesting the charged service --></requestingOrganization>
 <costCenter><!-- 0..1 Reference(Organization) Organization that has ownership of the (potential, future) revenue --></costCenter>
 <quantity><!-- 0..1 Quantity Quantity of which the charge item has been serviced --></quantity>
 <bodysite><!-- 0..* CodeableConcept Anatomical location, if relevant --></bodysite>
 <unitPriceComponent><!-- 0..1 MonetaryComponent Unit price overriding the associated rules --></unitPriceComponent>
 <totalPriceComponent><!-- 0..1 MonetaryComponent Total price overriding the associated rules --></totalPriceComponent>
 <overrideReason><!-- 0..1 CodeableConcept Reason for overriding the list price/factor --></overrideReason>
 <enterer><!-- 0..1 Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Individual who was entering --></enterer>
 <enteredDate value="[dateTime]"/><!-- 0..1 Date the charge item was entered -->
 <reason><!-- 0..* CodeableConcept Why was the charged  service rendered? --></reason>
 <service><!-- 0..* CodeableReference(DiagnosticReport|ImagingStudy|Immunization|
   MedicationAdministration|MedicationDispense|MedicationRequest|Observation|
   Procedure|ServiceRequest|SupplyDelivery) Which rendered service is being charged? --></service>
 <product><!-- 0..* CodeableReference(Device|Medication|Substance) Product charged --></product>
 <account><!-- 0..* Reference(Account) Account to place this charge --></account>
 <note><!-- 0..* Annotation Comments made about the ChargeItem --></note>
 <supportingInformation><!-- 0..* Reference(Any) Further information supporting this charge --></supportingInformation>
</ChargeItem>

JSON Template

{
  "resourceType" : "ChargeItem",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier for item
  "definitionUri" : ["<uri>"], // Defining information about the code of this charge item
  "definitionCanonical" : ["<canonical(ChargeItemDefinition)>"], // Resource defining the code of this ChargeItem
  "status" : "<code>", // R!  planned | billable | not-billable | aborted | billed | entered-in-error | unknown
  "partOf" : [{ Reference(ChargeItem) }], // Part of referenced ChargeItem
  "code" : { CodeableConcept }, // R!  A code that identifies the charge, like a billing code
  "subject" : { Reference(Group|Patient) }, // R!  Individual service was done for/to
  "encounter" : { Reference(Encounter) }, // Encounter associated with this ChargeItem
  // occurrence[x]: When the charged service was applied. One of these 3:
  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "occurrenceTiming" : { Timing },
  "performer" : [{ // Who performed charged service
    "function" : { CodeableConcept }, // What type of performance was done
    "actor" : { Reference(CareTeam|Device|HealthcareService|Organization|
    Patient|Practitioner|PractitionerRole|RelatedPerson) } // R!  Individual who was performing
  }],
  "performingOrganization" : { Reference(Organization) }, // Organization providing the charged service
  "requestingOrganization" : { Reference(Organization) }, // Organization requesting the charged service
  "costCenter" : { Reference(Organization) }, // Organization that has ownership of the (potential, future) revenue
  "quantity" : { Quantity }, // Quantity of which the charge item has been serviced
  "bodysite" : [{ CodeableConcept }], // Anatomical location, if relevant
  "unitPriceComponent" : { MonetaryComponent }, // Unit price overriding the associated rules
  "totalPriceComponent" : { MonetaryComponent }, // Total price overriding the associated rules
  "overrideReason" : { CodeableConcept }, // Reason for overriding the list price/factor
  "enterer" : { Reference(Device|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) }, // Individual who was entering
  "enteredDate" : "<dateTime>", // Date the charge item was entered
  "reason" : [{ CodeableConcept }], // Why was the charged  service rendered?
  "service" : [{ CodeableReference(DiagnosticReport|ImagingStudy|Immunization|
   MedicationAdministration|MedicationDispense|MedicationRequest|Observation|
   Procedure|ServiceRequest|SupplyDelivery) }], // Which rendered service is being charged?
  "product" : [{ CodeableReference(Device|Medication|Substance) }], // Product charged
  "account" : [{ Reference(Account) }], // Account to place this charge
  "note" : [{ Annotation }], // Comments made about the ChargeItem
  "supportingInformation" : [{ Reference(Any) }] // Further information supporting this charge
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:ChargeItem;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business Identifier for item
  fhir:definitionUri  ( [ uri ] ... ) ; # 0..* Defining information about the code of this charge item
  fhir:definitionCanonical  ( [ canonical(ChargeItemDefinition) ] ... ) ; # 0..* Resource defining the code of this ChargeItem
  fhir:status [ code ] ; # 1..1 planned | billable | not-billable | aborted | billed | entered-in-error | unknown
  fhir:partOf  ( [ Reference(ChargeItem) ] ... ) ; # 0..* Part of referenced ChargeItem
  fhir:code [ CodeableConcept ] ; # 1..1 A code that identifies the charge, like a billing code
  fhir:subject [ Reference(Group|Patient) ] ; # 1..1 Individual service was done for/to
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 Encounter associated with this ChargeItem
  # occurrence[x] : 0..1 When the charged service was applied. One of these 3
    fhir:occurrence [  a fhir:dateTime ; dateTime ]
    fhir:occurrence [  a fhir:Period ; Period ]
    fhir:occurrence [  a fhir:Timing ; Timing ]
  fhir:performer ( [ # 0..* Who performed charged service
    fhir:function [ CodeableConcept ] ; # 0..1 What type of performance was done
    fhir:actor [ Reference(CareTeam|Device|HealthcareService|Organization|Patient|Practitioner|
  PractitionerRole|RelatedPerson) ] ; # 1..1 Individual who was performing
  ] ... ) ;
  fhir:performingOrganization [ Reference(Organization) ] ; # 0..1 Organization providing the charged service
  fhir:requestingOrganization [ Reference(Organization) ] ; # 0..1 Organization requesting the charged service
  fhir:costCenter [ Reference(Organization) ] ; # 0..1 Organization that has ownership of the (potential, future) revenue
  fhir:quantity [ Quantity ] ; # 0..1 Quantity of which the charge item has been serviced
  fhir:bodysite  ( [ CodeableConcept ] ... ) ; # 0..* Anatomical location, if relevant
  fhir:unitPriceComponent [ MonetaryComponent ] ; # 0..1 Unit price overriding the associated rules
  fhir:totalPriceComponent [ MonetaryComponent ] ; # 0..1 Total price overriding the associated rules
  fhir:overrideReason [ CodeableConcept ] ; # 0..1 Reason for overriding the list price/factor
  fhir:enterer [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Individual who was entering
  fhir:enteredDate [ dateTime ] ; # 0..1 Date the charge item was entered
  fhir:reason  ( [ CodeableConcept ] ... ) ; # 0..* Why was the charged  service rendered?
  fhir:service  ( [ CodeableReference(DiagnosticReport|ImagingStudy|Immunization|MedicationAdministration|
  MedicationDispense|MedicationRequest|Observation|Procedure|ServiceRequest|
  SupplyDelivery) ] ... ) ; # 0..* Which rendered service is being charged?
  fhir:product  ( [ CodeableReference(Device|Medication|Substance) ] ... ) ; # 0..* Product charged
  fhir:account  ( [ Reference(Account) ] ... ) ; # 0..* Account to place this charge
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Comments made about the ChargeItem
  fhir:supportingInformation  ( [ Reference(Any) ] ... ) ; # 0..* Further information supporting this charge
]

Changes from both R4 and R4B

ChargeItem

ChargeItem.encounter

Added Element

ChargeItem.performer.actor

Type Reference: Added Target Type HealthcareService

ChargeItem.unitPriceComponent

Added Element

ChargeItem.totalPriceComponent

Added Element

ChargeItem.overrideReason

Type changed from string to CodeableConcept

ChargeItem.service

Type changed from Reference(DiagnosticReport | ImagingStudy | Immunization | MedicationAdministration | MedicationDispense | Observation | Procedure | SupplyDelivery) to CodeableReference

ChargeItem.product

Renamed from product[x] to product
Max Cardinality changed from 1 to *
Add Type CodeableReference
Remove Types Reference(Device | Medication | Substance), CodeableConcept

ChargeItem.context

Deleted

ChargeItem.factorOverride

Deleted

ChargeItem.priceOverride

Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

8.27.4.1 Terminology Bindings

Path	ValueSet	Type	Documentation
ChargeItem.status	ChargeItemStatus	Required	Codes identifying the lifecycle stage of a ChargeItem.
ChargeItem.code	ChargeItemCode	Example	Example set of codes that can be used for billing purposes.
ChargeItem.performer.function	ProcedurePerformerRoleCodes	Example	This example value set defines the set of codes that can be used to indicate a role of a procedure performer.
ChargeItem.bodysite	SNOMEDCTBodyStructures	Example	This value set includes all codes from SNOMED CT where concept is-a 442083009 (Anatomical or acquired body site (body structure)).
ChargeItem.overrideReason	??	Example
ChargeItem.reason	ICD10Codes (a valid code from ICD-10 )	Example	This value set includes sample ICD-10 codes.
ChargeItem.product	DeviceType	Example	Codes used to identify medical devices. Includes concepts from SNOMED CT (http://www.snomed.org/) where concept is-a 49062001 (Device) and is provided as a suggestive example.

Path

ValueSet

Type

Documentation

ChargeItem.status

ChargeItemStatus

Required

Codes identifying the lifecycle stage of a ChargeItem.

ChargeItem.code

ChargeItemCode

Example

Example set of codes that can be used for billing purposes.

ChargeItem.performer.function

ProcedurePerformerRoleCodes

Example

This example value set defines the set of codes that can be used to indicate a role of a procedure performer.

ChargeItem.bodysite

SNOMEDCTBodyStructures

Example

This value set includes all codes from SNOMED CT icon where concept is-a 442083009 (Anatomical or acquired body site (body structure)).

ChargeItem.overrideReason

Example

ChargeItem.reason

ICD10Codes (a valid code from ICD-10 icon

)

Example

This value set includes sample ICD-10 codes.

ChargeItem.product

DeviceType

Example

Codes used to identify medical devices. Includes concepts from SNOMED CT (http://www.snomed.org/) where concept is-a 49062001 (Device) and is provided as a suggestive example.

8.27.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name	Type	Description	Expression	In Common
account	reference	Account to place this charge	ChargeItem.account (Account)
code	token	A code that identifies the charge, like a billing code	ChargeItem.code	22 Resources
encounter	reference	Encounter associated with event	ChargeItem.encounter (Encounter)	29 Resources
entered-date	date	Date the charge item was entered	ChargeItem.enteredDate
enterer	reference	Individual who was entering	ChargeItem.enterer (Practitioner, Organization, Device, Patient, PractitionerRole, RelatedPerson)
factor-override	number	Factor overriding the associated rules	ChargeItem.totalPriceComponent.factor
identifier	token	Business Identifier for item	ChargeItem.identifier	65 Resources
occurrence	date	When the charged service was applied	ChargeItem.occurrence.ofType(dateTime) \| ChargeItem.occurrence.ofType(Period) \| ChargeItem.occurrence.ofType(Timing)
patient	reference	Individual service was done for/to	ChargeItem.subject.where(resolve() is Patient) (Patient)	66 Resources
performer-actor	reference	Individual who was performing	ChargeItem.performer.actor (Practitioner, Organization, CareTeam, Device, Patient, HealthcareService, PractitionerRole, RelatedPerson)
performer-function	token	What type of performance was done	ChargeItem.performer.function
performing-organization	reference	Organization providing the charged service	ChargeItem.performingOrganization (Organization)
price-override	quantity	Price overriding the associated rules	ChargeItem.totalPriceComponent.amount
quantity	quantity	Quantity of which the charge item has been serviced	ChargeItem.quantity
requesting-organization	reference	Organization requesting the charged service	ChargeItem.requestingOrganization (Organization)
service	reference	Which rendered service is being charged?	ChargeItem.service.reference
status	token	Is this charge item active	ChargeItem.status
subject	reference	Individual service was done for/to	ChargeItem.subject (Group, Patient)