Patient Cost Transparency Implementation Guide
2.0.0-ballot - STU 2 Ballot US

This page is part of the Da Vinci Patient Cost Transparency Implementation Guide (v2.0.0-ballot: STU 2 Ballot) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: PCTGFESummary - Mappings

Page standards status: Trial-use Maturity Level: 1

Mappings for the davinci-pct-gfe-summary resource profile.

Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

PCTGFESummary
ClaimRequest
   identifierRequest.identifier
   identifier (INTER)Request.identifier
   statusRequest.status
   patientRequest.subject
   createdRequest.authoredOn
   insurerRequest.performer
   providerRequest.requester
   priorityRequest.priority
   related
      claimRequest.replaces
   diagnosisRequest.reasonReference
   diagnosis (principal)Request.reasonReference
   diagnosis (admitting)Request.reasonReference
   diagnosis (patientReasonForVisit)Request.reasonReference
   diagnosis (externalcauseofinjury)Request.reasonReference
   diagnosis (other)Request.reasonReference
   insurance
      identifierRequest.identifier

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

PCTGFESummary
Claim
   identifierFiveWs.identifier
   identifier (INTER)FiveWs.identifier
   statusFiveWs.status
   typeFiveWs.class
   useFiveWs.class
   patientFiveWs.subject[x], FiveWs.subject
   billablePeriodFiveWs.done[x]
   createdFiveWs.recorded
   providerFiveWs.source
   careTeam
      providerFiveWs.actor
   careTeam (attending)
      providerFiveWs.actor
   careTeam (operating)
      providerFiveWs.actor
   careTeam (rendering)
      providerFiveWs.actor
   careTeam (referring)
      providerFiveWs.actor
   insurance
      identifierFiveWs.identifier

Mappings for RIM Mapping (http://hl7.org/v3)

PCTGFESummary
ClaimEntity. Role, or Act
   textAct.text?
   containedN/A
   modifierExtensionN/A
   identifier
   identifier (INTER)
      idn/a
      extensionn/a
      useRole.code or implied by context
      typeRole.code or implied by context
      systemII.root or Role.id.root
      valueII.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
      periodRole.effectiveTime or implied by context
      assignerII.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
   provider
      idn/a
      extension
      extension (dataAbsentReason)ANY.nullFlavor
         idn/a
         urlN/A
         value[x]N/A
   related
      idn/a
      extensionn/a
      modifierExtensionN/A
   careTeam
      idn/a
      extensionn/a
      modifierExtensionN/A
   careTeam (attending)
      idn/a
      extensionn/a
      modifierExtensionN/A
   careTeam (operating)
      idn/a
      extensionn/a
      modifierExtensionN/A
   careTeam (rendering)
      idn/a
      extensionn/a
      modifierExtensionN/A
   careTeam (referring)
      idn/a
      extensionn/a
      modifierExtensionN/A
   diagnosis
      idn/a
      extensionn/a
      modifierExtensionN/A
   diagnosis (principal)
      idn/a
      extensionn/a
      modifierExtensionN/A
   diagnosis (admitting)
      idn/a
      extensionn/a
      modifierExtensionN/A
   diagnosis (patientReasonForVisit)
      idn/a
      extensionn/a
      modifierExtensionN/A
   diagnosis (externalcauseofinjury)
      idn/a
      extensionn/a
      modifierExtensionN/A
   diagnosis (other)
      idn/a
      extensionn/a
      modifierExtensionN/A
   procedure
      idn/a
      modifierExtensionN/A
   procedure (principal)
      idn/a
      extensionn/a
      modifierExtensionN/A
   procedure (other)
      idn/a
      extensionn/a
      modifierExtensionN/A
   insuranceCoverage
      idn/a
      extensionn/a
      modifierExtensionN/A
   accident
      idn/a
      extensionn/a
      modifierExtensionN/A
      location[x]
         idn/a
         extensionn/a
         useunique(./use)
         typeunique(./use)
         text./formatted
         lineAD.part[parttype = AL]
         cityAD.part[parttype = CTY]
         districtAD.part[parttype = CNT | CPA]
         stateAD.part[parttype = STA]
         postalCodeAD.part[parttype = ZIP]
         countryAD.part[parttype = CNT]
         period./usablePeriod[type="IVL<TS>"]