Left: | QICore Claim (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim) |
Right: | QICore Claim (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim) |
Error | StructureDefinition.version | Values for version differ: '6.0.0-ballot' vs '6.0.0' |
Information | StructureDefinition.publisher | Values for publisher differ: 'http://www.hl7.org/Special/committees/cqi/index.cfm' vs 'HL7 International / Clinical Quality Information' |
Information | StructureDefinition.short | Values for short differ: 'The recipient of the products and services' vs '(QI-Core) The recipient of the products and services' |
Warning | Claim.patient | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | StructureDefinition.short | Values for short differ: 'Relevant time frame for the claim' vs '(QI-Core) Relevant time frame for the claim' |
Warning | Claim.billablePeriod | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | StructureDefinition.short | Values for short differ: 'Resource creation date' vs '(QI-Core) Resource creation date' |
Warning | Claim.created | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | StructureDefinition.short | Values for short differ: 'Party responsible for the claim' vs '(QI-Core) Party responsible for the claim' |
Warning | Claim.provider | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | StructureDefinition.short | Values for short differ: 'Prescription authorizing services and products' vs '(QI-Core) Prescription authorizing services and products' |
Warning | Claim.prescription | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | StructureDefinition.short | Values for short differ: 'Diagnosis instance identifier' vs '(QI-Core) Diagnosis instance identifier' |
Warning | Claim.diagnosis.sequence | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | StructureDefinition.short | Values for short differ: 'Nature of illness or problem' vs '(QI-Core) Nature of illness or problem' |
Warning | Claim.diagnosis.diagnosis[x] | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | StructureDefinition.short | Values for short differ: 'Present on admission' vs '(QI-Core) Present on admission' |
Warning | Claim.diagnosis.onAdmission | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | StructureDefinition.short | Values for short differ: 'Procedure instance identifier' vs '(QI-Core) Procedure instance identifier' |
Warning | Claim.procedure.sequence | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | StructureDefinition.short | Values for short differ: 'Specific clinical procedure' vs '(QI-Core) Specific clinical procedure' |
Warning | Claim.procedure.procedure[x] | Elements differ in definition for mustSupport: 'true' vs 'false' |
Information | StructureDefinition.short | Values for short differ: 'Encounters related to this billed item' vs '(QI-Core) Encounters related to this billed item' |
Warning | Claim.item.encounter | Elements differ in definition for mustSupport: 'true' vs 'false' |
Name | Value | Comments | |
---|---|---|---|
abstract | false | ||
baseDefinition | http://hl7.org/fhir/StructureDefinition/Claim | ||
copyright | |||
date | 2018-08-22 | ||
description | Profile of Claim for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors. | ||
experimental | false | ||
fhirVersion | 4.0.1 | ||
jurisdiction | |||
jurisdiction[0] | urn:iso:std:iso:3166#US | ||
kind | resource | ||
name | QICoreClaim | ||
publisher | http://www.hl7.org/Special/committees/cqi/index.cfm | HL7 International / Clinical Quality Information |
|
purpose | |||
status | active | ||
title | QICore Claim | ||
type | Claim | ||
url | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim | ||
version | 6.0.0-ballot | 6.0.0 |
|
Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | L Type | L Description & Constraints | Comments | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Claim | 0..* | Claim | Claim, Pre-determination or Pre-authorization | 0..* | Claim | Claim, Pre-determination or Pre-authorization | |||||||||||
id | Σ | 0..1 | id | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact | |||||||||
meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource | |||||||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created | |||||||||
language | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| |||||||||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||||||||
contained | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |||||||||
identifier | 0..* | Identifier | Business Identifier for claim | 0..* | Identifier | Business Identifier for claim | |||||||||||
status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | |||||||||
type | Σ | 1..1 | CodeableConcept | Category or discipline Binding: ?? (extensible): The type or discipline-style of the claim. | Σ | 1..1 | CodeableConcept | Category or discipline Binding: ?? (extensible): The type or discipline-style of the claim. | |||||||||
subType | 0..1 | CodeableConcept | More granular claim type Binding: ?? (example): A more granular claim typecode. | 0..1 | CodeableConcept | More granular claim type Binding: ?? (example): A more granular claim typecode. | |||||||||||
use | Σ | 1..1 | code | claim | preauthorization | predetermination Binding: ?? (required): The purpose of the Claim: predetermination, preauthorization, claim. | Σ | 1..1 | code | claim | preauthorization | predetermination Binding: ?? (required): The purpose of the Claim: predetermination, preauthorization, claim. | |||||||||
patient | SΣ | 1..1 | Reference(QICore Patient) | The recipient of the products and services | Σ | 1..1 | Reference(QICore Patient) | (QI-Core) The recipient of the products and services |
| ||||||||
billablePeriod | SΣ | 0..1 | Period | Relevant time frame for the claim | Σ | 0..1 | Period | (QI-Core) Relevant time frame for the claim |
| ||||||||
created | SΣ | 1..1 | dateTime | Resource creation date | Σ | 1..1 | dateTime | (QI-Core) Resource creation date |
| ||||||||
enterer | 0..1 | Reference(Practitioner | PractitionerRole) | Author of the claim | 0..1 | Reference(Practitioner | PractitionerRole) | Author of the claim | |||||||||||
insurer | Σ | 0..1 | Reference(Organization) | Target | Σ | 0..1 | Reference(Organization) | Target | |||||||||
provider | SΣ | 1..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization) | Party responsible for the claim | Σ | 1..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization) | (QI-Core) Party responsible for the claim |
| ||||||||
priority | Σ | 1..1 | CodeableConcept | Desired processing ugency Binding: ?? (example): The timeliness with which processing is required: stat, normal, deferred. | Σ | 1..1 | CodeableConcept | Desired processing ugency Binding: ?? (example): The timeliness with which processing is required: stat, normal, deferred. | |||||||||
fundsReserve | 0..1 | CodeableConcept | For whom to reserve funds Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None). | 0..1 | CodeableConcept | For whom to reserve funds Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None). | |||||||||||
related | 0..* | BackboneElement | Prior or corollary claims | 0..* | BackboneElement | Prior or corollary claims | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
claim | 0..1 | Reference(Claim) | Reference to the related claim | 0..1 | Reference(Claim) | Reference to the related claim | |||||||||||
relationship | 0..1 | CodeableConcept | How the reference claim is related Binding: ?? (example): Relationship of this claim to a related Claim. | 0..1 | CodeableConcept | How the reference claim is related Binding: ?? (example): Relationship of this claim to a related Claim. | |||||||||||
reference | 0..1 | Identifier | File or case reference | 0..1 | Identifier | File or case reference | |||||||||||
prescription | S | 0..1 | Reference(QICore DeviceRequest | QICore MedicationRequest | VisionPrescription) | Prescription authorizing services and products | 0..1 | Reference(QICore DeviceRequest | QICore MedicationRequest | VisionPrescription) | (QI-Core) Prescription authorizing services and products |
| |||||||||
originalPrescription | 0..1 | Reference(DeviceRequest | MedicationRequest | VisionPrescription) | Original prescription if superseded by fulfiller | 0..1 | Reference(DeviceRequest | MedicationRequest | VisionPrescription) | Original prescription if superseded by fulfiller | |||||||||||
payee | 0..1 | BackboneElement | Recipient of benefits payable | 0..1 | BackboneElement | Recipient of benefits payable | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
type | 1..1 | CodeableConcept | Category of recipient Binding: ?? (example): A code for the party to be reimbursed. | 1..1 | CodeableConcept | Category of recipient Binding: ?? (example): A code for the party to be reimbursed. | |||||||||||
party | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson) | Recipient reference | 0..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization | QICore Patient | QICore RelatedPerson) | Recipient reference | |||||||||||
referral | 0..1 | Reference(QICore ServiceRequest) | Treatment referral | 0..1 | Reference(QICore ServiceRequest) | Treatment referral | |||||||||||
facility | 0..1 | Reference(QICore Location) | Servicing facility | 0..1 | Reference(QICore Location) | Servicing facility | |||||||||||
careTeam | 0..* | BackboneElement | Members of the care team | 0..* | BackboneElement | Members of the care team | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
sequence | 1..1 | positiveInt | Order of care team | 1..1 | positiveInt | Order of care team | |||||||||||
provider | 1..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization) | Practitioner or organization | 1..1 | Reference(QICore Practitioner | QICore PractitionerRole | QICore Organization) | Practitioner or organization | |||||||||||
responsible | 0..1 | boolean | Indicator of the lead practitioner | 0..1 | boolean | Indicator of the lead practitioner | |||||||||||
role | 0..1 | CodeableConcept | Function within the team Binding: ?? (example): The role codes for the care team members. | 0..1 | CodeableConcept | Function within the team Binding: ?? (example): The role codes for the care team members. | |||||||||||
qualification | 0..1 | CodeableConcept | Practitioner credential or specialization Binding: ?? (example): Provider professional qualifications. | 0..1 | CodeableConcept | Practitioner credential or specialization Binding: ?? (example): Provider professional qualifications. | |||||||||||
supportingInfo | 0..* | BackboneElement | Supporting information | 0..* | BackboneElement | Supporting information | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
sequence | 1..1 | positiveInt | Information instance identifier | 1..1 | positiveInt | Information instance identifier | |||||||||||
category | 1..1 | CodeableConcept | Classification of the supplied information Binding: ?? (example): The valuset used for additional information category codes. | 1..1 | CodeableConcept | Classification of the supplied information Binding: ?? (example): The valuset used for additional information category codes. | |||||||||||
code | 0..1 | CodeableConcept | Type of information Binding: ?? (example): The valuset used for additional information codes. | 0..1 | CodeableConcept | Type of information Binding: ?? (example): The valuset used for additional information codes. | |||||||||||
timing[x] | 0..1 | date, Period | When it occurred | 0..1 | date, Period | When it occurred | |||||||||||
value[x] | 0..1 | boolean, string, Quantity, Attachment, Reference(Resource) | Data to be provided | 0..1 | boolean, string, Quantity, Attachment, Reference(Resource) | Data to be provided | |||||||||||
reason | 0..1 | CodeableConcept | Explanation for the information Binding: ?? (example): Reason codes for the missing teeth. | 0..1 | CodeableConcept | Explanation for the information Binding: ?? (example): Reason codes for the missing teeth. | |||||||||||
diagnosis | 0..* | BackboneElement | Pertinent diagnosis information | 0..* | BackboneElement | Pertinent diagnosis information | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
sequence | S | 1..1 | positiveInt | Diagnosis instance identifier | 1..1 | positiveInt | (QI-Core) Diagnosis instance identifier |
| |||||||||
diagnosis[x] | S | 1..1 | CodeableConcept, Reference(QICore Condition Encounter Diagnosis) | Nature of illness or problem Binding: ?? (example): Example ICD10 Diagnostic codes. | 1..1 | CodeableConcept, Reference(QICore Condition Encounter Diagnosis) | (QI-Core) Nature of illness or problem Binding: ?? (example): Example ICD10 Diagnostic codes. |
| |||||||||
type | 0..* | CodeableConcept | Timing or nature of the diagnosis Binding: ?? (example): The type of the diagnosis: admitting, principal, discharge. | 0..* | CodeableConcept | Timing or nature of the diagnosis Binding: ?? (example): The type of the diagnosis: admitting, principal, discharge. | |||||||||||
onAdmission | S | 0..1 | CodeableConcept | Present on admission Binding: ?? (required): Present on admission. | 0..1 | CodeableConcept | (QI-Core) Present on admission Binding: ?? (required): Present on admission. |
| |||||||||
packageCode | 0..1 | CodeableConcept | Package billing code Binding: ?? (example): The DRG codes associated with the diagnosis. | 0..1 | CodeableConcept | Package billing code Binding: ?? (example): The DRG codes associated with the diagnosis. | |||||||||||
procedure | 0..* | BackboneElement | Clinical procedures performed | 0..* | BackboneElement | Clinical procedures performed | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
sequence | S | 1..1 | positiveInt | Procedure instance identifier | 1..1 | positiveInt | (QI-Core) Procedure instance identifier |
| |||||||||
type | 0..* | CodeableConcept | Category of Procedure Binding: ?? (example): Example procedure type codes. | 0..* | CodeableConcept | Category of Procedure Binding: ?? (example): Example procedure type codes. | |||||||||||
date | 0..1 | dateTime | When the procedure was performed | 0..1 | dateTime | When the procedure was performed | |||||||||||
procedure[x] | S | 1..1 | CodeableConcept, Reference(QICore Procedure) | Specific clinical procedure Binding: ?? (example): Example ICD10 Procedure codes. | 1..1 | CodeableConcept, Reference(QICore Procedure) | (QI-Core) Specific clinical procedure Binding: ?? (example): Example ICD10 Procedure codes. |
| |||||||||
udi | 0..* | Reference(Device) | Unique device identifier | 0..* | Reference(Device) | Unique device identifier | |||||||||||
insurance | Σ | 1..* | BackboneElement | Patient insurance information | Σ | 1..* | BackboneElement | Patient insurance information | |||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
sequence | Σ | 1..1 | positiveInt | Insurance instance identifier | Σ | 1..1 | positiveInt | Insurance instance identifier | |||||||||
focal | Σ | 1..1 | boolean | Coverage to be used for adjudication | Σ | 1..1 | boolean | Coverage to be used for adjudication | |||||||||
identifier | 0..1 | Identifier | Pre-assigned Claim number | 0..1 | Identifier | Pre-assigned Claim number | |||||||||||
coverage | Σ | 1..1 | Reference(Coverage) | Insurance information | Σ | 1..1 | Reference(Coverage) | Insurance information | |||||||||
businessArrangement | 0..1 | string | Additional provider contract number | 0..1 | string | Additional provider contract number | |||||||||||
preAuthRef | 0..* | string | Prior authorization reference number | 0..* | string | Prior authorization reference number | |||||||||||
claimResponse | 0..1 | Reference(ClaimResponse) | Adjudication results | 0..1 | Reference(ClaimResponse) | Adjudication results | |||||||||||
accident | 0..1 | BackboneElement | Details of the event | 0..1 | BackboneElement | Details of the event | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
date | 1..1 | date | When the incident occurred | 1..1 | date | When the incident occurred | |||||||||||
type | 0..1 | CodeableConcept | The nature of the accident Binding: ?? (extensible): Type of accident: work place, auto, etc. | 0..1 | CodeableConcept | The nature of the accident Binding: ?? (extensible): Type of accident: work place, auto, etc. | |||||||||||
location[x] | 0..1 | Address, Reference(Location) | Where the event occurred | 0..1 | Address, Reference(Location) | Where the event occurred | |||||||||||
item | 0..* | BackboneElement | Product or service provided | 0..* | BackboneElement | Product or service provided | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
sequence | 1..1 | positiveInt | Item instance identifier | 1..1 | positiveInt | Item instance identifier | |||||||||||
careTeamSequence | 0..* | positiveInt | Applicable careTeam members | 0..* | positiveInt | Applicable careTeam members | |||||||||||
diagnosisSequence | 0..* | positiveInt | Applicable diagnoses | 0..* | positiveInt | Applicable diagnoses | |||||||||||
procedureSequence | 0..* | positiveInt | Applicable procedures | 0..* | positiveInt | Applicable procedures | |||||||||||
informationSequence | 0..* | positiveInt | Applicable exception and supporting information | 0..* | positiveInt | Applicable exception and supporting information | |||||||||||
revenue | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. | |||||||||||
category | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. | |||||||||||
productOrService | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. | |||||||||||
modifier | 0..* | CodeableConcept | Product or service billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | 0..* | CodeableConcept | Product or service billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||||||||||
programCode | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. | |||||||||||
serviced[x] | 0..1 | date, Period | Date or dates of service or product delivery | 0..1 | date, Period | Date or dates of service or product delivery | |||||||||||
location[x] | 0..1 | CodeableConcept, Address, Reference(Location) | Place of service or where product was supplied Binding: ?? (example): Place of service: pharmacy, school, prison, etc. | 0..1 | CodeableConcept, Address, Reference(Location) | Place of service or where product was supplied Binding: ?? (example): Place of service: pharmacy, school, prison, etc. | |||||||||||
quantity | 0..1 | ?? | Count of products or services | 0..1 | ?? | Count of products or services | |||||||||||
unitPrice | 0..1 | Money | Fee, charge or cost per item | 0..1 | Money | Fee, charge or cost per item | |||||||||||
factor | 0..1 | decimal | Price scaling factor | 0..1 | decimal | Price scaling factor | |||||||||||
net | 0..1 | Money | Total item cost | 0..1 | Money | Total item cost | |||||||||||
udi | 0..* | Reference(Device) | Unique device identifier | 0..* | Reference(Device) | Unique device identifier | |||||||||||
bodySite | 0..1 | CodeableConcept | Anatomical location Binding: ?? (example): The code for the teeth, quadrant, sextant and arch. | 0..1 | CodeableConcept | Anatomical location Binding: ?? (example): The code for the teeth, quadrant, sextant and arch. | |||||||||||
subSite | 0..* | CodeableConcept | Anatomical sub-location Binding: ?? (example): The code for the tooth surface and surface combinations. | 0..* | CodeableConcept | Anatomical sub-location Binding: ?? (example): The code for the tooth surface and surface combinations. | |||||||||||
encounter | S | 0..* | Reference(QICore Encounter) | Encounters related to this billed item | 0..* | Reference(QICore Encounter) | (QI-Core) Encounters related to this billed item |
| |||||||||
detail | 0..* | BackboneElement | Product or service provided | 0..* | BackboneElement | Product or service provided | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
sequence | 1..1 | positiveInt | Item instance identifier | 1..1 | positiveInt | Item instance identifier | |||||||||||
revenue | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. | |||||||||||
category | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. | |||||||||||
productOrService | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. | |||||||||||
modifier | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||||||||||
programCode | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. | |||||||||||
quantity | 0..1 | ?? | Count of products or services | 0..1 | ?? | Count of products or services | |||||||||||
unitPrice | 0..1 | Money | Fee, charge or cost per item | 0..1 | Money | Fee, charge or cost per item | |||||||||||
factor | 0..1 | decimal | Price scaling factor | 0..1 | decimal | Price scaling factor | |||||||||||
net | 0..1 | Money | Total item cost | 0..1 | Money | Total item cost | |||||||||||
udi | 0..* | Reference(Device) | Unique device identifier | 0..* | Reference(Device) | Unique device identifier | |||||||||||
subDetail | 0..* | BackboneElement | Product or service provided | 0..* | BackboneElement | Product or service provided | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
sequence | 1..1 | positiveInt | Item instance identifier | 1..1 | positiveInt | Item instance identifier | |||||||||||
revenue | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. | 0..1 | CodeableConcept | Revenue or cost center code Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products. | |||||||||||
category | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses. | |||||||||||
productOrService | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. | |||||||||||
modifier | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||||||||||
programCode | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. | |||||||||||
quantity | 0..1 | ?? | Count of products or services | 0..1 | ?? | Count of products or services | |||||||||||
unitPrice | 0..1 | Money | Fee, charge or cost per item | 0..1 | Money | Fee, charge or cost per item | |||||||||||
factor | 0..1 | decimal | Price scaling factor | 0..1 | decimal | Price scaling factor | |||||||||||
net | 0..1 | Money | Total item cost | 0..1 | Money | Total item cost | |||||||||||
udi | 0..* | Reference(Device) | Unique device identifier | 0..* | Reference(Device) | Unique device identifier | |||||||||||
total | 0..1 | Money | Total claim cost | 0..1 | Money | Total claim cost | |||||||||||
Documentation for this format |