<status value="draft"/> <date value="2025-10-15T12:16:02+00:00"/> <publisher value="ELGA GmbH"/> <contact> <name value="ELGA GmbH"/> <telecom> <system value="url"/> <value value="https://elga.gv.at"/> </telecom> </contact> <description value="MOPED Profil für die Anfrage der Versichertenanspruchserklärung VAE."/> <fhirVersion value="5.0.0"/> <mapping> <identity value="workflow"/> <uri value="http://hl7.org/fhir/workflow"/> <name value="Workflow Pattern"/> </mapping> <mapping> <identity value="w5"/> <uri value="http://hl7.org/fhir/fivews"/> <name value="FiveWs Pattern Mapping"/> </mapping> <mapping> <identity value="rim"/> <uri value="http://hl7.org/v3"/> <name value="RIM Mapping"/> </mapping> <kind value="resource"/> <abstract value="false"/> <type value="Claim"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Claim"/> <derivation value="constraint"/> <snapshot> <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version"> <valueString value="5.0.0"/> </extension> <element id="Claim"> <path value="Claim"/> <short value="Claim, Pre-determination or Pre-authorization"/> <definition value="A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement."/> <comment value="The Claim resource fulfills three information request requirements: Claim - a request for adjudication for reimbursement for products and/or services provided; Preauthorization - a request to authorize the future provision of products and/or services including an anticipated adjudication; and, Predetermination - a request for a non-bind adjudication of possible future products and/or services."/> <alias value="Adjudication Request"/> <alias value="Preauthorization Request"/> <alias value="Predetermination Request"/> <min value="0"/> <max value="*"/> <base> <path value="Claim"/> <min value="0"/> <max value="*"/> </base> <constraint> <key value="dom-2"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> <expression value="contained.contained.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-3"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource"/> <expression value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-4"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/> <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <key value="dom-5"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> <expression value="contained.meta.security.empty()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <constraint> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation"> <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/> </extension> <key value="dom-6"/> <severity value="warning"/> <human value="A resource should have narrative for robust management"/> <expression value="text.`div`.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/DomainResource"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Entity, Role, or Act"/> </mapping> <mapping> <identity value="workflow"/> <map value="Request"/> </mapping> <mapping> <identity value="w5"/> <map value="financial.billing"/> </mapping> </element> <element id="Claim.id"> <path value="Claim.id"/> <short value="Logical id of this artifact"/> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/> <comment value="Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="Claim.meta"> <path value="Claim.meta"/> <short value="Metadata about the resource"/> <definition value="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."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.meta"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Meta"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="Claim.implicitRules"> <path value="Claim.implicitRules"/> <short value="A set of rules under which this content was created"/> <definition value="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."/> <comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.implicitRules"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation"/> <isSummary value="true"/> </element> <element id="Claim.language"> <path value="Claim.language"/> <short value="Language of the resource content"/> <definition value="The base language in which the resource is written."/> <comment value="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)."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.language"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language"/> </extension> <strength value="required"/> <description value="IETF language tag for a human language"/> <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|5.0.0"/> <additional> <purpose value="starter"/> <valueSet value="http://hl7.org/fhir/ValueSet/languages|5.0.0"/> </additional> </binding> </element> <element id="Claim.text"> <path value="Claim.text"/> <short value="Text summary of the resource, for human interpretation"/> <definition value="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."/> <comment value="Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later."/> <alias value="narrative"/> <alias value="html"/> <alias value="xhtml"/> <alias value="display"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Narrative"/> </type> <condition value="dom-6"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Act.text?"/> </mapping> </element> <element id="Claim.contained"> <path value="Claim.contained"/> <short value="Contained, inline Resources"/> <definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning."/> <comment value="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."/> <alias value="inline resources"/> <alias value="anonymous resources"/> <alias value="contained resources"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.contained"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Resource"/> </type> <condition value="dom-2"/> <condition value="dom-4"/> <condition value="dom-3"/> <condition value="dom-5"/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.extension"> <path value="Claim.extension"/> <short value="Additional content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.modifierExtension"> <path value="Claim.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.identifier"> <path value="Claim.identifier"/> <short value="Business Identifier for claim"/> <definition value="A unique identifier assigned to this claim."/> <requirements value="Allows claims to be distinguished and referenced."/> <alias value="Claim Number"/> <min value="0"/> <max value="*"/> <base> <path value="Claim.identifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.identifier"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.identifier"/> </mapping> </element> <element id="Claim.traceNumber"> <path value="Claim.traceNumber"/> <short value="Number for tracking"/> <definition value="Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners."/> <requirements value="Allows partners to uniquely identify components for tracking."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.traceNumber"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.status"> <path value="Claim.status"/> <short value="active | cancelled | draft | entered-in-error"/> <definition value="The status of the resource instance."/> <comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid."/> <requirements value="Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.status"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ClaimStatus"/> </extension> <strength value="required"/> <description value="A code specifying the state of the resource instance."/> <valueSet value="http://hl7.org/fhir/ValueSet/fm-status|5.0.0"/> </binding> <mapping> <identity value="workflow"/> <map value="Request.status"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.status"/> </mapping> </element> <element id="Claim.type"> <path value="Claim.type"/> <short value="Category or discipline"/> <definition value="The category of claim, e.g. oral, pharmacy, vision, institutional, professional."/> <comment value="The code system provides oral, pharmacy, vision, professional and institutional claim types. Those supported depends on the requirements of the jurisdiction. The valueset is extensible to accommodate other types of claims as required by the jurisdiction."/> <requirements value="Claim type determine the general sets of business rules applied for information requirements and adjudication."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.type"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <patternCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/claim-type"/> <code value="institutional"/> </coding> </patternCodeableConcept> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ClaimType"/> </extension> <strength value="extensible"/> <description value="The type or discipline-style of the claim."/> <valueSet value="http://hl7.org/fhir/ValueSet/claim-type|5.0.0"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.class"/> </mapping> </element> <element id="Claim.subType"> <path value="Claim.subType"/> <short value="More granular claim type"/> <definition value="A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service."/> <comment value="This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type."/> <requirements value="Some jurisdictions need a finer grained claim type for routing and adjudication."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.subType"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ClaimSubType"/> </extension> <strength value="example"/> <description value="A more granular claim typecode."/> <valueSet value="http://hl7.org/fhir/ValueSet/claim-subtype|5.0.0"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.class"/> </mapping> </element> <element id="Claim.use"> <path value="Claim.use"/> <short value="claim | preauthorization | predetermination"/> <definition value="A code to indicate whether the nature of the request is: Claim - A request to an Insurer to adjudicate the supplied charges for health care goods and services under the identified policy and to pay the determined Benefit amount, if any; Preauthorization - A request to an Insurer to adjudicate the supplied proposed future charges for health care goods and services under the identified policy and to approve the services and provide the expected benefit amounts and potentially to reserve funds to pay the benefits when Claims for the indicated services are later submitted; or, Pre-determination - A request to an Insurer to adjudicate the supplied 'what if' charges for health care goods and services under the identified policy and report back what the Benefit payable would be had the services actually been provided."/> <requirements value="This element is required to understand the nature of the request for adjudication."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.use"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <patternCode value="preauthorization"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Use"/> </extension> <strength value="required"/> <description value="The purpose of the Claim: predetermination, preauthorization, claim."/> <valueSet value="http://hl7.org/fhir/ValueSet/claim-use|5.0.0"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.class"/> </mapping> </element> <element id="Claim.patient"> <path value="Claim.patient"/> <short value="The recipient of the products and services"/> <definition value="The party to whom the professional services and/or products have been supplied or are being considered and for whom actual or forecast reimbursement is sought."/> <requirements value="The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.patient"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.at/fhir/HL7ATCoreProfiles/5.0.0/StructureDefinition/at-core-patient"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Request.subject"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.subject[x]"/> </mapping> </element> <element id="Claim.billablePeriod"> <path value="Claim.billablePeriod"/> <short value="Relevant time frame for the claim"/> <definition value="The period for which charges are being submitted."/> <comment value="Typically this would be today or in the past for a claim, and today or in the future for preauthorizations and predeterminations. Typically line item dates of service should fall within the billing period if one is specified."/> <requirements value="A number jurisdictions required the submission of the billing period when submitting claims for example for hospital stays or long-term care."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.billablePeriod"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Period"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.done[x]"/> </mapping> </element> <element id="Claim.created"> <path value="Claim.created"/> <short value="Resource creation date"/> <definition value="The date this resource was created."/> <comment value="This field is independent of the date of creation of the resource as it may reflect the creation date of a source document prior to digitization. Typically for claims all services must be completed as of this date."/> <requirements value="Need to record a timestamp for use by both the recipient and the issuer."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.created"/> <min value="1"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Request.authoredOn"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.recorded"/> </mapping> </element> <element id="Claim.enterer"> <path value="Claim.enterer"/> <short value="Author of the claim"/> <definition value="Individual who created the claim, predetermination or preauthorization."/> <requirements value="Some jurisdictions require the contact information for personnel completing claims."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.enterer"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="w5"/> <map value="FiveWs.author"/> </mapping> </element> <element id="Claim.insurer"> <path value="Claim.insurer"/> <short value="Target"/> <definition value="The Insurer who is target of the request."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.insurer"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="https://elga.moped.at/StructureDefinition/SVOrganization"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Request.performer"/> </mapping> </element> <element id="Claim.provider"> <path value="Claim.provider"/> <short value="Party responsible for the claim"/> <definition value="The provider which is responsible for the claim, predetermination or preauthorization."/> <comment value="Typically this field would be 1..1 where this party is accountable for the data content within the claim but is not necessarily the facility, provider group or practitioner who provided the products and services listed within this claim resource. This field is the Billing Provider, for example, a facility, provider group, lab or practitioner."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.provider"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="https://elga.moped.at/StructureDefinition/KHOrganization"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Request.requester"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.source"/> </mapping> </element> <element id="Claim.priority"> <path value="Claim.priority"/> <short value="Desired processing urgency"/> <definition value="The provider-required urgency of processing the request. Typical values include: stat, normal, deferred."/> <comment value="If a claim processor is unable to complete the processing as per the priority then they should generate an error and not process the request."/> <requirements value="The provider may need to indicate their processing requirements so that the processor can indicate if they are unable to comply."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.priority"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ProcessPriority"/> </extension> <strength value="example"/> <description value="The timeliness with which processing is required: stat, normal, deferred."/> <valueSet value="http://hl7.org/fhir/ValueSet/process-priority|5.0.0"/> </binding> <mapping> <identity value="workflow"/> <map value="Request.priority"/> </mapping> </element> <element id="Claim.fundsReserve"> <path value="Claim.fundsReserve"/> <short value="For whom to reserve funds"/> <definition value="A code to indicate whether and for whom funds are to be reserved for future claims."/> <comment value="This field is only used for preauthorizations."/> <requirements value="In the case of a Pre-Determination/Pre-Authorization the provider may request that funds in the amount of the expected Benefit be reserved ('Patient' or 'Provider') to pay for the Benefits determined on the subsequent claim(s). 'None' explicitly indicates no funds reserving is requested."/> <alias value="Fund pre-allocation"/> <min value="0"/> <max value="1"/> <base> <path value="Claim.fundsReserve"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="FundsReserve"/> </extension> <strength value="example"/> <description value="For whom funds are to be reserved: (Patient, Provider, None)."/> <valueSet value="http://hl7.org/fhir/ValueSet/fundsreserve|5.0.0"/> </binding> </element> <element id="Claim.related"> <path value="Claim.related"/> <short value="Prior or corollary claims"/> <definition value="Other claims which are related to this claim such as prior submissions or claims for related services or for the same event."/> <comment value="For example, for the original treatment and follow-up exams."/> <requirements value="For workplace or other accidents it is common to relate separate claims arising from the same event."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.related"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.related.id"> <path value="Claim.related.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.related.extension"> <path value="Claim.related.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.related.modifierExtension"> <path value="Claim.related.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.related.claim"> <path value="Claim.related.claim"/> <short value="Reference to the related claim"/> <definition value="Reference to a related claim."/> <requirements value="For workplace or other accidents it is common to relate separate claims arising from the same event."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.related.claim"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-hierarchy"> <valueBoolean value="false"/> </extension> <code value="Reference"/> <targetProfile value="https://elga.moped.at/StructureDefinition/MopedVAERequest"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.replaces"/> </mapping> </element> <element id="Claim.related.relationship"> <path value="Claim.related.relationship"/> <short value="How the reference claim is related"/> <definition value="A code to convey how the claims are related."/> <comment value="For example, prior claim or umbrella."/> <requirements value="Some insurers need a declaration of the type of relationship."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.related.relationship"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="RelatedClaimRelationship"/> </extension> <strength value="example"/> <description value="Relationship of this claim to a related Claim."/> <valueSet value="http://hl7.org/fhir/ValueSet/related-claim-relationship|5.0.0"/> </binding> </element> <element id="Claim.related.reference"> <path value="Claim.related.reference"/> <short value="File or case reference"/> <definition value="An alternate organizational reference to the case or file to which this particular claim pertains."/> <comment value="For example, Property/Casualty insurer claim # or Workers Compensation case # ."/> <requirements value="In cases where an event-triggered claim is being submitted to an insurer which requires a reference number to be specified on all exchanges."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.related.reference"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.prescription"> <path value="Claim.prescription"/> <short value="Prescription authorizing services and products"/> <definition value="Prescription is the document/authorization given to the claim author for them to provide products and services for which consideration (reimbursement) is sought. Could be a RX for medications, an 'order' for oxygen or wheelchair or physiotherapy treatments."/> <requirements value="Required to authorize the dispensing of controlled substances and devices."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.prescription"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceRequest|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/VisionPrescription|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.originalPrescription"> <path value="Claim.originalPrescription"/> <short value="Original prescription if superseded by fulfiller"/> <definition value="Original prescription which has been superseded by this prescription to support the dispensing of pharmacy services, medications or products."/> <comment value="For example, a physician may prescribe a medication which the pharmacy determines is contraindicated, or for which the patient has an intolerance, and therefore issues a new prescription for an alternate medication which has the same therapeutic intent. The prescription from the pharmacy becomes the 'prescription' and that from the physician becomes the 'original prescription'."/> <requirements value="Often required when a fulfiller varies what is fulfilled from that authorized on the original prescription."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.originalPrescription"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceRequest|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/VisionPrescription|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.payee"> <path value="Claim.payee"/> <short value="Recipient of benefits payable"/> <definition value="The party to be reimbursed for cost of the products and services according to the terms of the policy."/> <comment value="Often providers agree to receive the benefits payable to reduce the near-term costs to the patient. The insurer may decline to pay the provider and choose to pay the subscriber instead."/> <requirements value="The provider needs to specify who they wish to be reimbursed and the claims processor needs express who they will reimburse."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.payee"/> <min value="0"/> <max value="1"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.payee.id"> <path value="Claim.payee.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.payee.extension"> <path value="Claim.payee.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.payee.modifierExtension"> <path value="Claim.payee.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.payee.type"> <path value="Claim.payee.type"/> <short value="Category of recipient"/> <definition value="Type of Party to be reimbursed: subscriber, provider, other."/> <requirements value="Need to know who should receive payment with the most common situations being the Provider (assignment of benefits) or the Subscriber."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.payee.type"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="PayeeType"/> </extension> <strength value="example"/> <description value="A code for the party to be reimbursed."/> <valueSet value="http://hl7.org/fhir/ValueSet/payeetype|5.0.0"/> </binding> </element> <element id="Claim.payee.party"> <path value="Claim.payee.party"/> <short value="Recipient reference"/> <definition value="Reference to the individual or organization to whom any payment will be made."/> <comment value="Not required if the payee is 'subscriber' or 'provider'."/> <requirements value="Need to provide demographics if the payee is not 'subscriber' nor 'provider'."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.payee.party"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.referral"> <path value="Claim.referral"/> <short value="Treatment referral"/> <definition value="The referral information received by the claim author, it is not to be used when the author generates a referral for a patient. A copy of that referral may be provided as supporting information. Some insurers require proof of referral to pay for services or to pay specialist rates for services."/> <comment value="The referral resource which lists the date, practitioner, reason and other supporting information."/> <requirements value="Some insurers require proof of referral to pay for services or to pay specialist rates for services."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.referral"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="w5"/> <map value="FiveWs.cause"/> </mapping> </element> <element id="Claim.encounter"> <path value="Claim.encounter"/> <slicing> <discriminator> <type value="profile"/> <path value="resolve()"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> <short value="Encounters associated with the listed treatments"/> <definition value="Healthcare encounters related to this claim."/> <comment value="This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter."/> <requirements value="Used in some jurisdictions to link clinical events to claim items."/> <min value="1"/> <max value="*"/> <base> <path value="Claim.encounter"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.encounter:MopedEncounter"> <path value="Claim.encounter"/> <sliceName value="MopedEncounter"/> <short value="Generelle Informationen zu Aufnahme und Entlassung des Patienten"/> <definition value="Healthcare encounters related to this claim."/> <comment value="This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter."/> <requirements value="Used in some jurisdictions to link clinical events to claim items."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.encounter"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="https://elga.moped.at/StructureDefinition/MopedEncounter"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.encounter:TransferEncounter"> <path value="Claim.encounter"/> <sliceName value="TransferEncounter"/> <short value="Informationen zu Verlegungen innerhalb oder zwischen Krankenanstalten"/> <definition value="Healthcare encounters related to this claim."/> <comment value="This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter."/> <requirements value="Used in some jurisdictions to link clinical events to claim items."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.encounter"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="https://elga.moped.at/StructureDefinition/MopedTransferEncounter"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.facility"> <path value="Claim.facility"/> <short value="Servicing facility"/> <definition value="Facility where the services were provided."/> <requirements value="Insurance adjudication can be dependant on where services were delivered."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.facility"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="w5"/> <map value="FiveWs.where[x]"/> </mapping> </element> <element id="Claim.diagnosisRelatedGroup"> <path value="Claim.diagnosisRelatedGroup"/> <short value="Package billing code"/> <definition value="A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system."/> <comment value="For example DRG (Diagnosis Related Group) or a bundled billing code. A patient may have a diagnosis of a Myocardial Infarction and a DRG for HeartAttack would be assigned. The Claim item (and possible subsequent claims) would refer to the DRG for those line items that were for services related to the heart attack event."/> <requirements value="Required to relate the current diagnosis to a package billing code that is then referenced on the individual claim items which are specific to the health condition covered by the package code."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.diagnosisRelatedGroup"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosisRelatedGroup"/> </extension> <strength value="example"/> <valueSet value="http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup|5.0.0"/> </binding> </element> <element id="Claim.event"> <path value="Claim.event"/> <short value="Event information"/> <definition value="Information code for an event with a corresponding date or period."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.event"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.event.id"> <path value="Claim.event.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.event.extension"> <path value="Claim.event.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.event.modifierExtension"> <path value="Claim.event.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.event.type"> <path value="Claim.event.type"/> <short value="Specific event"/> <definition value="A coded event such as when a service is expected or a card printed."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.event.type"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DatesType"/> </extension> <strength value="example"/> <valueSet value="http://hl7.org/fhir/ValueSet/datestype|5.0.0"/> </binding> </element> <element id="Claim.event.when[x]"> <path value="Claim.event.when[x]"/> <short value="Occurance date or period"/> <definition value="A date or period in the past or future indicating when the event occurred or is expectd to occur."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.event.when[x]"/> <min value="1"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <type> <code value="Period"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.careTeam"> <path value="Claim.careTeam"/> <short value="Members of the care team"/> <definition value="The members of the team who provided the products and services."/> <requirements value="Common to identify the responsible and supporting practitioners."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.careTeam"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.careTeam.id"> <path value="Claim.careTeam.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.careTeam.extension"> <path value="Claim.careTeam.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.careTeam.modifierExtension"> <path value="Claim.careTeam.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.careTeam.sequence"> <path value="Claim.careTeam.sequence"/> <short value="Order of care team"/> <definition value="A number to uniquely identify care team entries."/> <requirements value="Necessary to maintain the order of the care team and provide a mechanism to link individuals to claim details."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.careTeam.sequence"/> <min value="1"/> <max value="1"/> </base> <type> <code value="positiveInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.careTeam.provider"> <path value="Claim.careTeam.provider"/> <short value="Practitioner or organization"/> <definition value="Member of the team who provided the product or service."/> <requirements value="Often a regulatory requirement to specify the responsible provider."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.careTeam.provider"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Organization|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="w5"/> <map value="FiveWs.actor"/> </mapping> </element> <element id="Claim.careTeam.responsible"> <path value="Claim.careTeam.responsible"/> <short value="Indicator of the lead practitioner"/> <definition value="The party who is billing and/or responsible for the claimed products or services."/> <comment value="Responsible might not be required when there is only a single provider listed."/> <requirements value="When multiple parties are present it is required to distinguish the lead or responsible individual."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.careTeam.responsible"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.careTeam.role"> <path value="Claim.careTeam.role"/> <short value="Function within the team"/> <definition value="The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team."/> <comment value="Role might not be required when there is only a single provider listed."/> <requirements value="When multiple parties are present it is required to distinguish the roles performed by each member."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.careTeam.role"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="CareTeamRole"/> </extension> <strength value="example"/> <description value="The role codes for the care team members."/> <valueSet value="http://hl7.org/fhir/ValueSet/claim-careteamrole|5.0.0"/> </binding> </element> <element id="Claim.careTeam.specialty"> <path value="Claim.careTeam.specialty"/> <short value="Practitioner or provider specialization"/> <definition value="The specialization of the practitioner or provider which is applicable for this service."/> <requirements value="Need to specify which specialization a practitioner or provider acting under when delivering the product or service."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.careTeam.specialty"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ProviderQualification"/> </extension> <strength value="example"/> <valueSet value="http://hl7.org/fhir/ValueSet/provider-qualification|5.0.0"/> </binding> </element> <element id="Claim.supportingInfo"> <path value="Claim.supportingInfo"/> <slicing> <discriminator> <type value="value"/> <path value="category"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> <short value="Supporting information"/> <definition value="Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues."/> <comment value="Often there are multiple jurisdiction specific valuesets which are required."/> <requirements value="Typically these information codes are required to support the services rendered or the adjudication of the services rendered."/> <alias value="Attachments Exception Codes Occurrence Codes Value codes"/> <min value="1"/> <max value="*"/> <base> <path value="Claim.supportingInfo"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.supportingInfo"/> </mapping> </element> <element id="Claim.supportingInfo.id"> <path value="Claim.supportingInfo.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo.extension"> <path value="Claim.supportingInfo.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo.modifierExtension"> <path value="Claim.supportingInfo.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.supportingInfo.sequence"> <path value="Claim.supportingInfo.sequence"/> <short value="Information instance identifier"/> <definition value="A number to uniquely identify supporting information entries."/> <requirements value="Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.supportingInfo.sequence"/> <min value="1"/> <max value="1"/> </base> <type> <code value="positiveInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.supportingInfo.category"> <path value="Claim.supportingInfo.category"/> <short value="Classification of the supplied information"/> <definition value="The general class of the information supplied: information; exception; accident, employment; onset, etc."/> <comment value="This may contain a category for the local bill type codes."/> <requirements value="Required to group or associate information items with common characteristics. For example: admission information or prior treatments."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.supportingInfo.category"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="InformationCategory"/> </extension> <strength value="example"/> <description value="The valuset used for additional information category codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0"/> </binding> </element> <element id="Claim.supportingInfo.code"> <path value="Claim.supportingInfo.code"/> <short value="Type of information"/> <definition value="System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought."/> <requirements value="Required to identify the kind of additional information."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.supportingInfo.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="InformationCode"/> </extension> <strength value="example"/> <description value="The valuset used for additional information codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/claim-exception|5.0.0"/> </binding> </element> <element id="Claim.supportingInfo.code.id"> <path value="Claim.supportingInfo.code.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo.code.extension"> <path value="Claim.supportingInfo.code.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo.code.coding"> <path value="Claim.supportingInfo.code.coding"/> <short value="Code defined by a terminology system"/> <definition value="A reference to a code defined by a terminology system."/> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true."/> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems."/> <min value="0"/> <max value="*"/> <base> <path value="CodeableConcept.coding"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="required"/> <valueSet value="https://elga.moped.at/ValueSet/VAESupportingInformationCategoryVS"/> </binding> <mapping> <identity value="v2"/> <map value="C*E.1-8, C*E.10-22"/> </mapping> <mapping> <identity value="rim"/> <map value="union(., ./translation)"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/> </mapping> </element> <element id="Claim.supportingInfo.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Claim.supportingInfo.code.text"/> <short value="Plain text representation of the concept"/> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user."/> <comment value="Very often the text is the same as a displayName of one of the codings."/> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source."/> <min value="0"/> <max value="1"/> <base> <path value="CodeableConcept.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.9. But note many systems use C*E.2 for this"/> </mapping> <mapping> <identity value="rim"/> <map value="./originalText[mediaType/code="text/plain"]/data"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/> </mapping> </element> <element id="Claim.supportingInfo.timing[x]"> <path value="Claim.supportingInfo.timing[x]"/> <short value="When it occurred"/> <definition value="The date when or period to which this information refers."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.supportingInfo.timing[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="date"/> </type> <type> <code value="Period"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.supportingInfo.value[x]"> <path value="Claim.supportingInfo.value[x]"/> <short value="Data to be provided"/> <definition value="Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data."/> <comment value="Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident."/> <requirements value="To convey the data content to be provided when the information is more than a simple code or period."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.supportingInfo.value[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <type> <code value="string"/> </type> <type> <code value="Quantity"/> </type> <type> <code value="Attachment"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource|5.0.0"/> </type> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.supportingInfo.reason"> <path value="Claim.supportingInfo.reason"/> <short value="Explanation for the information"/> <definition value="Provides the reason in the situation where a reason code is required in addition to the content."/> <comment value="For example: the reason for the additional stay, or why a tooth is missing."/> <requirements value="Needed when the supporting information has both a date and amount/value and requires explanation."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.supportingInfo.reason"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MissingReason"/> </extension> <strength value="example"/> <description value="Reason codes for the missing teeth."/> <valueSet value="http://hl7.org/fhir/ValueSet/missing-tooth-reason|5.0.0"/> </binding> </element> <element id="Claim.supportingInfo:Sonderklasse"> <path value="Claim.supportingInfo"/> <sliceName value="Sonderklasse"/> <short value="Allgemeine Gebührenklasse/Sonderklasse"/> <definition value="Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues."/> <comment value="Often there are multiple jurisdiction specific valuesets which are required."/> <requirements value="Typically these information codes are required to support the services rendered or the adjudication of the services rendered."/> <alias value="Attachments Exception Codes Occurrence Codes Value codes"/> <min value="0"/> <max value="*"/> <base> <path value="Claim.supportingInfo"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.supportingInfo"/> </mapping> </element> <element id="Claim.supportingInfo:Sonderklasse.id"> <path value="Claim.supportingInfo.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo:Sonderklasse.extension"> <path value="Claim.supportingInfo.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo:Sonderklasse.modifierExtension"> <path value="Claim.supportingInfo.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.supportingInfo:Sonderklasse.sequence"> <path value="Claim.supportingInfo.sequence"/> <short value="Information instance identifier"/> <definition value="A number to uniquely identify supporting information entries."/> <requirements value="Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.supportingInfo.sequence"/> <min value="1"/> <max value="1"/> </base> <type> <code value="positiveInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.supportingInfo:Sonderklasse.category"> <path value="Claim.supportingInfo.category"/> <short value="Classification of the supplied information"/> <definition value="The general class of the information supplied: information; exception; accident, employment; onset, etc."/> <comment value="This may contain a category for the local bill type codes."/> <requirements value="Required to group or associate information items with common characteristics. For example: admission information or prior treatments."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.supportingInfo.category"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <patternCodeableConcept> <coding> <system value="https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS"/> <code value="KLAS"/> </coding> </patternCodeableConcept> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="InformationCategory"/> </extension> <strength value="example"/> <description value="The valuset used for additional information category codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0"/> </binding> </element> <element id="Claim.supportingInfo:Sonderklasse.code"> <path value="Claim.supportingInfo.code"/> <short value="Type of information"/> <definition value="System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought."/> <requirements value="Required to identify the kind of additional information."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.supportingInfo.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="required"/> <valueSet value="https://elga.moped.at/ValueSet/SonderklasseVS"/> </binding> </element> <element id="Claim.supportingInfo:Sonderklasse.code.id"> <path value="Claim.supportingInfo.code.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo:Sonderklasse.code.extension"> <path value="Claim.supportingInfo.code.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo:Sonderklasse.code.coding"> <path value="Claim.supportingInfo.code.coding"/> <short value="Code defined by a terminology system"/> <definition value="A reference to a code defined by a terminology system."/> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true."/> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems."/> <min value="0"/> <max value="*"/> <base> <path value="CodeableConcept.coding"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="required"/> <valueSet value="https://elga.moped.at/ValueSet/VAESupportingInformationCategoryVS"/> </binding> <mapping> <identity value="v2"/> <map value="C*E.1-8, C*E.10-22"/> </mapping> <mapping> <identity value="rim"/> <map value="union(., ./translation)"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/> </mapping> </element> <element id="Claim.supportingInfo:Sonderklasse.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Claim.supportingInfo.code.text"/> <short value="Plain text representation of the concept"/> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user."/> <comment value="Very often the text is the same as a displayName of one of the codings."/> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source."/> <min value="0"/> <max value="1"/> <base> <path value="CodeableConcept.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.9. But note many systems use C*E.2 for this"/> </mapping> <mapping> <identity value="rim"/> <map value="./originalText[mediaType/code="text/plain"]/data"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/> </mapping> </element> <element id="Claim.supportingInfo:Sonderklasse.timing[x]"> <path value="Claim.supportingInfo.timing[x]"/> <slicing> <discriminator> <type value="type"/> <path value="$this"/> </discriminator> <ordered value="false"/> <rules value="closed"/> </slicing> <short value="When it occurred"/> <definition value="The date when or period to which this information refers."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.supportingInfo.timing[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Period"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.supportingInfo:Sonderklasse.timing[x]:timingPeriod"> <path value="Claim.supportingInfo.timing[x]"/> <sliceName value="timingPeriod"/> <short value="When it occurred"/> <definition value="The date when or period to which this information refers."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.supportingInfo.timing[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Period"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.supportingInfo:Sonderklasse.value[x]"> <path value="Claim.supportingInfo.value[x]"/> <short value="Data to be provided"/> <definition value="Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data."/> <comment value="Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident."/> <requirements value="To convey the data content to be provided when the information is more than a simple code or period."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.supportingInfo.value[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <type> <code value="string"/> </type> <type> <code value="Quantity"/> </type> <type> <code value="Attachment"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource|5.0.0"/> </type> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.supportingInfo:Sonderklasse.reason"> <path value="Claim.supportingInfo.reason"/> <short value="Explanation for the information"/> <definition value="Provides the reason in the situation where a reason code is required in addition to the content."/> <comment value="For example: the reason for the additional stay, or why a tooth is missing."/> <requirements value="Needed when the supporting information has both a date and amount/value and requires explanation."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.supportingInfo.reason"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MissingReason"/> </extension> <strength value="example"/> <description value="Reason codes for the missing teeth."/> <valueSet value="http://hl7.org/fhir/ValueSet/missing-tooth-reason|5.0.0"/> </binding> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden"> <path value="Claim.supportingInfo"/> <sliceName value="VerdachtFremdverschulden"/> <short value="Verdacht auf Fremdversschluden"/> <definition value="Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues."/> <comment value="Often there are multiple jurisdiction specific valuesets which are required."/> <requirements value="Typically these information codes are required to support the services rendered or the adjudication of the services rendered."/> <alias value="Attachments Exception Codes Occurrence Codes Value codes"/> <min value="1"/> <max value="1"/> <base> <path value="Claim.supportingInfo"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.supportingInfo"/> </mapping> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden.id"> <path value="Claim.supportingInfo.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden.extension"> <path value="Claim.supportingInfo.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden.modifierExtension"> <path value="Claim.supportingInfo.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden.sequence"> <path value="Claim.supportingInfo.sequence"/> <short value="Information instance identifier"/> <definition value="A number to uniquely identify supporting information entries."/> <requirements value="Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.supportingInfo.sequence"/> <min value="1"/> <max value="1"/> </base> <type> <code value="positiveInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden.category"> <path value="Claim.supportingInfo.category"/> <short value="Classification of the supplied information"/> <definition value="The general class of the information supplied: information; exception; accident, employment; onset, etc."/> <comment value="This may contain a category for the local bill type codes."/> <requirements value="Required to group or associate information items with common characteristics. For example: admission information or prior treatments."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.supportingInfo.category"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <patternCodeableConcept> <coding> <system value="https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS"/> <code value="FREVER"/> </coding> </patternCodeableConcept> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="InformationCategory"/> </extension> <strength value="example"/> <description value="The valuset used for additional information category codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0"/> </binding> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden.code"> <path value="Claim.supportingInfo.code"/> <short value="Type of information"/> <definition value="System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought."/> <requirements value="Required to identify the kind of additional information."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.supportingInfo.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="InformationCode"/> </extension> <strength value="example"/> <description value="The valuset used for additional information codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/claim-exception|5.0.0"/> </binding> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden.code.id"> <path value="Claim.supportingInfo.code.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden.code.extension"> <path value="Claim.supportingInfo.code.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden.code.coding"> <path value="Claim.supportingInfo.code.coding"/> <short value="Code defined by a terminology system"/> <definition value="A reference to a code defined by a terminology system."/> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true."/> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems."/> <min value="0"/> <max value="*"/> <base> <path value="CodeableConcept.coding"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="required"/> <valueSet value="https://elga.moped.at/ValueSet/VAESupportingInformationCategoryVS"/> </binding> <mapping> <identity value="v2"/> <map value="C*E.1-8, C*E.10-22"/> </mapping> <mapping> <identity value="rim"/> <map value="union(., ./translation)"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/> </mapping> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Claim.supportingInfo.code.text"/> <short value="Plain text representation of the concept"/> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user."/> <comment value="Very often the text is the same as a displayName of one of the codings."/> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source."/> <min value="0"/> <max value="1"/> <base> <path value="CodeableConcept.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.9. But note many systems use C*E.2 for this"/> </mapping> <mapping> <identity value="rim"/> <map value="./originalText[mediaType/code="text/plain"]/data"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/> </mapping> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden.timing[x]"> <path value="Claim.supportingInfo.timing[x]"/> <short value="When it occurred"/> <definition value="The date when or period to which this information refers."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.supportingInfo.timing[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="date"/> </type> <type> <code value="Period"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden.value[x]"> <path value="Claim.supportingInfo.value[x]"/> <short value="Data to be provided"/> <definition value="Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data."/> <comment value="Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident."/> <requirements value="To convey the data content to be provided when the information is more than a simple code or period."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.supportingInfo.value[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden.reason"> <path value="Claim.supportingInfo.reason"/> <short value="Explanation for the information"/> <definition value="Provides the reason in the situation where a reason code is required in addition to the content."/> <comment value="For example: the reason for the additional stay, or why a tooth is missing."/> <requirements value="Needed when the supporting information has both a date and amount/value and requires explanation."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.supportingInfo.reason"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MissingReason"/> </extension> <strength value="example"/> <description value="Reason codes for the missing teeth."/> <valueSet value="http://hl7.org/fhir/ValueSet/missing-tooth-reason|5.0.0"/> </binding> </element> <element id="Claim.supportingInfo:Verlaengerungstage"> <path value="Claim.supportingInfo"/> <sliceName value="Verlaengerungstage"/> <short value="Anzahl der Verlängerungstage"/> <definition value="Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues."/> <comment value="Often there are multiple jurisdiction specific valuesets which are required."/> <requirements value="Typically these information codes are required to support the services rendered or the adjudication of the services rendered."/> <alias value="Attachments Exception Codes Occurrence Codes Value codes"/> <min value="0"/> <max value="1"/> <base> <path value="Claim.supportingInfo"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.supportingInfo"/> </mapping> </element> <element id="Claim.supportingInfo:Verlaengerungstage.id"> <path value="Claim.supportingInfo.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo:Verlaengerungstage.extension"> <path value="Claim.supportingInfo.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo:Verlaengerungstage.modifierExtension"> <path value="Claim.supportingInfo.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.supportingInfo:Verlaengerungstage.sequence"> <path value="Claim.supportingInfo.sequence"/> <short value="Information instance identifier"/> <definition value="A number to uniquely identify supporting information entries."/> <requirements value="Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.supportingInfo.sequence"/> <min value="1"/> <max value="1"/> </base> <type> <code value="positiveInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.supportingInfo:Verlaengerungstage.category"> <path value="Claim.supportingInfo.category"/> <short value="Classification of the supplied information"/> <definition value="The general class of the information supplied: information; exception; accident, employment; onset, etc."/> <comment value="This may contain a category for the local bill type codes."/> <requirements value="Required to group or associate information items with common characteristics. For example: admission information or prior treatments."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.supportingInfo.category"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <patternCodeableConcept> <coding> <system value="https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS"/> <code value="VERLAENG"/> </coding> </patternCodeableConcept> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="InformationCategory"/> </extension> <strength value="example"/> <description value="The valuset used for additional information category codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0"/> </binding> </element> <element id="Claim.supportingInfo:Verlaengerungstage.code"> <path value="Claim.supportingInfo.code"/> <short value="Type of information"/> <definition value="System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought."/> <requirements value="Required to identify the kind of additional information."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.supportingInfo.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="InformationCode"/> </extension> <strength value="example"/> <description value="The valuset used for additional information codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/claim-exception|5.0.0"/> </binding> </element> <element id="Claim.supportingInfo:Verlaengerungstage.code.id"> <path value="Claim.supportingInfo.code.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo:Verlaengerungstage.code.extension"> <path value="Claim.supportingInfo.code.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo:Verlaengerungstage.code.coding"> <path value="Claim.supportingInfo.code.coding"/> <short value="Code defined by a terminology system"/> <definition value="A reference to a code defined by a terminology system."/> <comment value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true."/> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems."/> <min value="0"/> <max value="*"/> <base> <path value="CodeableConcept.coding"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="required"/> <valueSet value="https://elga.moped.at/ValueSet/VAESupportingInformationCategoryVS"/> </binding> <mapping> <identity value="v2"/> <map value="C*E.1-8, C*E.10-22"/> </mapping> <mapping> <identity value="rim"/> <map value="union(., ./translation)"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/> </mapping> </element> <element id="Claim.supportingInfo:Verlaengerungstage.code.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Claim.supportingInfo.code.text"/> <short value="Plain text representation of the concept"/> <definition value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user."/> <comment value="Very often the text is the same as a displayName of one of the codings."/> <requirements value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source."/> <min value="0"/> <max value="1"/> <base> <path value="CodeableConcept.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.9. But note many systems use C*E.2 for this"/> </mapping> <mapping> <identity value="rim"/> <map value="./originalText[mediaType/code="text/plain"]/data"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/> </mapping> </element> <element id="Claim.supportingInfo:Verlaengerungstage.timing[x]"> <path value="Claim.supportingInfo.timing[x]"/> <short value="When it occurred"/> <definition value="The date when or period to which this information refers."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.supportingInfo.timing[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="date"/> </type> <type> <code value="Period"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.supportingInfo:Verlaengerungstage.value[x]"> <path value="Claim.supportingInfo.value[x]"/> <slicing> <discriminator> <type value="type"/> <path value="$this"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> <short value="Data to be provided"/> <definition value="Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data."/> <comment value="Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident."/> <requirements value="To convey the data content to be provided when the information is more than a simple code or period."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.supportingInfo.value[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <type> <code value="string"/> </type> <type> <code value="Quantity"/> </type> <type> <code value="Attachment"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource|5.0.0"/> </type> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.supportingInfo:Verlaengerungstage.value[x]:valueQuantity"> <path value="Claim.supportingInfo.value[x]"/> <sliceName value="valueQuantity"/> <short value="Data to be provided"/> <definition value="Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data."/> <comment value="Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident."/> <requirements value="To convey the data content to be provided when the information is more than a simple code or period."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.supportingInfo.value[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.supportingInfo:Verlaengerungstage.value[x]:valueQuantity.id"> <path value="Claim.supportingInfo.value[x].id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="id"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo:Verlaengerungstage.value[x]:valueQuantity.extension"> <path value="Claim.supportingInfo.value[x].extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.supportingInfo:Verlaengerungstage.value[x]:valueQuantity.value"> <path value="Claim.supportingInfo.value[x].value"/> <short value="Verlängerungstage"/> <definition value="The value of the measured amount. The value includes an implicit precision in the presentation of the value."/> <comment value="The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books)."/> <requirements value="Precision is handled implicitly in almost all cases of measurement."/> <min value="1"/> <max value="1"/> <base> <path value="Quantity.value"/> <min value="0"/> <max value="1"/> </base> <type> <code value="decimal"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="SN.2 / CQ - N/A"/> </mapping> <mapping> <identity value="rim"/> <map value="PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value"/> </mapping> </element> <element id="Claim.supportingInfo:Verlaengerungstage.value[x]:valueQuantity.comparator"> <path value="Claim.supportingInfo.value[x].comparator"/> <short value="< | <= | >= | > | ad - how to understand the value"/> <definition value="How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value."/> <requirements value="Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology."/> <min value="0"/> <max value="1"/> <base> <path value="Quantity.comparator"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <meaningWhenMissing value="If there is no comparator, then there is no modification of the value"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="true"/> <isModifierReason value="This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value"/> <isSummary value="true"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="QuantityComparator"/> </extension> <strength value="required"/> <description value="How the Quantity should be understood and represented."/> <valueSet value="http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0"/> </binding> <mapping> <identity value="v2"/> <map value="SN.1 / CQ.1"/> </mapping> <mapping> <identity value="rim"/> <map value="IVL properties"/> </mapping> </element> <element id="Claim.supportingInfo:Verlaengerungstage.value[x]:valueQuantity.unit"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Claim.supportingInfo.value[x].unit"/> <short value="Unit representation"/> <definition value="A human-readable form of the unit."/> <requirements value="There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms."/> <min value="0"/> <max value="1"/> <base> <path value="Quantity.unit"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <patternString value="day"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="(see OBX.6 etc.) / CQ.2"/> </mapping> <mapping> <identity value="rim"/> <map value="PQ.unit"/> </mapping> </element> <element id="Claim.supportingInfo:Verlaengerungstage.value[x]:valueQuantity.system"> <path value="Claim.supportingInfo.value[x].system"/> <short value="System that defines coded unit form"/> <definition value="The identification of the system that provides the coded form of the unit."/> <requirements value="Need to know the system that defines the coded form of the unit."/> <min value="0"/> <max value="1"/> <base> <path value="Quantity.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <patternUri value="http://unitsofmeasure.org"/> <condition value="qty-3"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="(see OBX.6 etc.) / CQ.2"/> </mapping> <mapping> <identity value="rim"/> <map value="CO.codeSystem, PQ.translation.codeSystem"/> </mapping> </element> <element id="Claim.supportingInfo:Verlaengerungstage.value[x]:valueQuantity.code"> <path value="Claim.supportingInfo.value[x].code"/> <short value="Coded form of the unit"/> <definition value="A computer processable form of the unit in some unit representation system."/> <comment value="The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system."/> <requirements value="Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest."/> <min value="0"/> <max value="1"/> <base> <path value="Quantity.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <patternCode value="day"/> <condition value="qty-3"/> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="(see OBX.6 etc.) / CQ.2"/> </mapping> <mapping> <identity value="rim"/> <map value="PQ.code, MO.currency, PQ.translation.code"/> </mapping> </element> <element id="Claim.supportingInfo:Verlaengerungstage.reason"> <path value="Claim.supportingInfo.reason"/> <short value="Explanation for the information"/> <definition value="Provides the reason in the situation where a reason code is required in addition to the content."/> <comment value="For example: the reason for the additional stay, or why a tooth is missing."/> <requirements value="Needed when the supporting information has both a date and amount/value and requires explanation."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.supportingInfo.reason"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="MissingReason"/> </extension> <strength value="example"/> <description value="Reason codes for the missing teeth."/> <valueSet value="http://hl7.org/fhir/ValueSet/missing-tooth-reason|5.0.0"/> </binding> </element> <element id="Claim.diagnosis"> <path value="Claim.diagnosis"/> <short value="Pertinent diagnosis information"/> <definition value="Information about diagnoses relevant to the claim items."/> <requirements value="Required for the adjudication by provided context for the services and product listed."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.diagnosis"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.reasonReference"/> </mapping> </element> <element id="Claim.diagnosis.id"> <path value="Claim.diagnosis.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.diagnosis.extension"> <path value="Claim.diagnosis.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.diagnosis.modifierExtension"> <path value="Claim.diagnosis.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.diagnosis.sequence"> <path value="Claim.diagnosis.sequence"/> <short value="Diagnosis instance identifier"/> <definition value="A number to uniquely identify diagnosis entries."/> <comment value="Diagnosis are presented in list order to their expected importance: primary, secondary, etc."/> <requirements value="Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.diagnosis.sequence"/> <min value="1"/> <max value="1"/> </base> <type> <code value="positiveInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.diagnosis.diagnosis[x]"> <path value="Claim.diagnosis.diagnosis[x]"/> <short value="Nature of illness or problem"/> <definition value="The nature of illness or problem in a coded form or as a reference to an external defined Condition."/> <requirements value="Provides health context for the evaluation of the products and/or services."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.diagnosis.diagnosis[x]"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Condition|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ICD10"/> </extension> <strength value="example"/> <description value="Example ICD10 Diagnostic codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/icd-10|5.0.0"/> </binding> </element> <element id="Claim.diagnosis.type"> <path value="Claim.diagnosis.type"/> <short value="Timing or nature of the diagnosis"/> <definition value="When the condition was observed or the relative ranking."/> <comment value="For example: admitting, primary, secondary, discharge."/> <requirements value="Often required to capture a particular diagnosis, for example: primary or discharge."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.diagnosis.type"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosisType"/> </extension> <strength value="example"/> <description value="The type of the diagnosis: admitting, principal, discharge."/> <valueSet value="http://hl7.org/fhir/ValueSet/ex-diagnosistype|5.0.0"/> </binding> </element> <element id="Claim.diagnosis.onAdmission"> <path value="Claim.diagnosis.onAdmission"/> <short value="Present on admission"/> <definition value="Gibt an ob die Diagnose bereits bei Aufnahme in den stationären Aufenthalt vorhanden war"/> <requirements value="Many systems need to understand for adjudication if the diagnosis was present a time of admission."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.diagnosis.onAdmission"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="DiagnosisOnAdmission"/> </extension> <strength value="example"/> <description value="Present on admission."/> <valueSet value="http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission|5.0.0"/> </binding> </element> <element id="Claim.procedure"> <path value="Claim.procedure"/> <short value="Clinical procedures performed"/> <definition value="Procedures performed on the patient relevant to the billing items with the claim."/> <requirements value="The specific clinical invention are sometimes required to be provided to justify billing a greater than customary amount for a service."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.procedure"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.procedure.id"> <path value="Claim.procedure.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.procedure.extension"> <path value="Claim.procedure.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.procedure.modifierExtension"> <path value="Claim.procedure.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.procedure.sequence"> <path value="Claim.procedure.sequence"/> <short value="Procedure instance identifier"/> <definition value="A number to uniquely identify procedure entries."/> <requirements value="Necessary to provide a mechanism to link to claim details."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.procedure.sequence"/> <min value="1"/> <max value="1"/> </base> <type> <code value="positiveInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.procedure.type"> <path value="Claim.procedure.type"/> <short value="Category of Procedure"/> <definition value="When the condition was observed or the relative ranking."/> <comment value="For example: primary, secondary."/> <requirements value="Often required to capture a particular diagnosis, for example: primary or discharge."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.procedure.type"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ProcedureType"/> </extension> <strength value="example"/> <description value="Example procedure type codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/ex-procedure-type|5.0.0"/> </binding> </element> <element id="Claim.procedure.date"> <path value="Claim.procedure.date"/> <short value="When the procedure was performed"/> <definition value="Date and optionally time the procedure was performed."/> <requirements value="Required for auditing purposes."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.procedure.date"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.procedure.procedure[x]"> <path value="Claim.procedure.procedure[x]"/> <short value="Specific clinical procedure"/> <definition value="The code or reference to a Procedure resource which identifies the clinical intervention performed."/> <requirements value="This identifies the actual clinical procedure."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.procedure.procedure[x]"/> <min value="1"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Procedure|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ICD10_Procedures"/> </extension> <strength value="example"/> <description value="Example ICD10 Procedure codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/icd-10-procedures|5.0.0"/> </binding> </element> <element id="Claim.procedure.udi"> <path value="Claim.procedure.udi"/> <short value="Unique device identifier"/> <definition value="Unique Device Identifiers associated with this line item."/> <requirements value="The UDI code allows the insurer to obtain device level information on the product supplied."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.procedure.udi"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.insurance"> <path value="Claim.insurance"/> <short value="Patient insurance information"/> <definition value="Financial instruments for reimbursement for the health care products and services specified on the claim."/> <comment value="All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'Coverage.subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim."/> <requirements value="At least one insurer is required for a claim to be a claim."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.insurance"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="Coverage"/> </mapping> </element> <element id="Claim.insurance.id"> <path value="Claim.insurance.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.insurance.extension"> <path value="Claim.insurance.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.insurance.modifierExtension"> <path value="Claim.insurance.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.insurance.sequence"> <path value="Claim.insurance.sequence"/> <short value="Insurance instance identifier"/> <definition value="A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order."/> <requirements value="To maintain order of the coverages."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.insurance.sequence"/> <min value="1"/> <max value="1"/> </base> <type> <code value="positiveInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="Claim.insurance.focal"> <path value="Claim.insurance.focal"/> <short value="Coverage to be used for adjudication"/> <definition value="A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true."/> <comment value="A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies."/> <requirements value="To identify which coverage in the list is being used to adjudicate this claim."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.insurance.focal"/> <min value="1"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="Claim.insurance.identifier"> <path value="Claim.insurance.identifier"/> <short value="Pre-assigned Claim number"/> <definition value="The business identifier to be used when the claim is sent for adjudication against this insurance policy."/> <comment value="Only required in jurisdictions where insurers, rather than the provider, are required to send claims to insurers that appear after them in the list. This element is not required when 'subrogation=true'."/> <requirements value="This will be the claim number should it be necessary to create this claim in the future. This is provided so that payors may forward claims to other payors in the Coordination of Benefit for adjudication rather than the provider being required to initiate each adjudication."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.insurance.identifier"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.identifier"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.identifier"/> </mapping> </element> <element id="Claim.insurance.coverage"> <path value="Claim.insurance.coverage"/> <short value="Insurance information"/> <definition value="Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system."/> <requirements value="Required to allow the adjudicator to locate the correct policy and history within their information system."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.insurance.coverage"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="https://elga.moped.at/StructureDefinition/MopedCoverage"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="Claim.insurance.businessArrangement"> <path value="Claim.insurance.businessArrangement"/> <short value="Additional provider contract number"/> <definition value="A business agreement number established between the provider and the insurer for special business processing purposes."/> <requirements value="Providers may have multiple business arrangements with a given insurer and must supply the specific contract number for adjudication."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.insurance.businessArrangement"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.insurance.preAuthRef"> <path value="Claim.insurance.preAuthRef"/> <short value="Prior authorization reference number"/> <definition value="Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization."/> <comment value="This value is an alphanumeric string that may be provided over the phone, via text, via paper, or within a ClaimResponse resource and is not a FHIR Identifier."/> <requirements value="Providers must quote previously issued authorization reference numbers in order to obtain adjudication as previously advised on the Preauthorization."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.insurance.preAuthRef"/> <min value="0"/> <max value="*"/> </base> <type> <code value="string"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.insurance.claimResponse"> <path value="Claim.insurance.claimResponse"/> <short value="Adjudication results"/> <definition value="The result of the adjudication of the line items for the Coverage specified in this insurance."/> <comment value="Must not be specified when 'focal=true' for this insurance."/> <requirements value="An insurer need the adjudication results from prior insurers to determine the outstanding balance remaining by item for the items in the curent claim."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.insurance.claimResponse"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ClaimResponse|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.accident"> <path value="Claim.accident"/> <short value="Details of the event"/> <definition value="Details of an accident which resulted in injuries which required the products and services listed in the claim."/> <requirements value="When healthcare products and services are accident related, benefits may be payable under accident provisions of policies, such as automotive, etc before they are payable under normal health insurance."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.accident"/> <min value="0"/> <max value="1"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.accident.id"> <path value="Claim.accident.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.accident.extension"> <path value="Claim.accident.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.accident.modifierExtension"> <path value="Claim.accident.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.accident.date"> <path value="Claim.accident.date"/> <short value="When the incident occurred"/> <definition value="Date of an accident event related to the products and services contained in the claim."/> <comment value="The date of the accident has to precede the dates of the products and services but within a reasonable timeframe."/> <requirements value="Required for audit purposes and adjudication."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.accident.date"/> <min value="1"/> <max value="1"/> </base> <type> <code value="date"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.accident.type"> <path value="Claim.accident.type"/> <short value="Verdacht auf Fremdversschluden"/> <definition value="The type or context of the accident event for the purposes of selection of potential insurance coverages and determination of coordination between insurers."/> <requirements value="Coverage may be dependant on the type of accident."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.accident.type"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="required"/> <valueSet value="https://elga.moped.at/ValueSet/VerdachtArbeitsSchuelerunfallVS"/> </binding> </element> <element id="Claim.accident.location[x]"> <path value="Claim.accident.location[x]"/> <short value="Where the event occurred"/> <definition value="The physical location of the accident event."/> <requirements value="Required for audit purposes and determination of applicable insurance liability."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.accident.location[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Address"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.patientPaid"> <path value="Claim.patientPaid"/> <short value="Paid by the patient"/> <definition value="The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services."/> <requirements value="Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.patientPaid"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Money"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item"> <path value="Claim.item"/> <short value="Product or service provided"/> <definition value="A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details."/> <requirements value="The items to be processed for adjudication."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.id"> <path value="Claim.item.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.item.extension"> <path value="Claim.item.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.item.modifierExtension"> <path value="Claim.item.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.item.sequence"> <path value="Claim.item.sequence"/> <short value="Item instance identifier"/> <definition value="A number to uniquely identify item entries."/> <requirements value="Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.item.sequence"/> <min value="1"/> <max value="1"/> </base> <type> <code value="positiveInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.traceNumber"> <path value="Claim.item.traceNumber"/> <short value="Number for tracking"/> <definition value="Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners."/> <requirements value="Allows partners to uniquely identify components for tracking."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.traceNumber"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.careTeamSequence"> <path value="Claim.item.careTeamSequence"/> <short value="Applicable careTeam members"/> <definition value="CareTeam members related to this service or product."/> <requirements value="Need to identify the individuals and their roles in the provision of the product or service."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.careTeamSequence"/> <min value="0"/> <max value="*"/> </base> <type> <code value="positiveInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.diagnosisSequence"> <path value="Claim.item.diagnosisSequence"/> <short value="Applicable diagnoses"/> <definition value="Diagnosis applicable for this service or product."/> <requirements value="Need to related the product or service to the associated diagnoses."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.diagnosisSequence"/> <min value="0"/> <max value="*"/> </base> <type> <code value="positiveInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.procedureSequence"> <path value="Claim.item.procedureSequence"/> <short value="Applicable procedures"/> <definition value="Procedures applicable for this service or product."/> <requirements value="Need to provide any listed specific procedures to support the product or service being claimed."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.procedureSequence"/> <min value="0"/> <max value="*"/> </base> <type> <code value="positiveInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.informationSequence"> <path value="Claim.item.informationSequence"/> <short value="Applicable exception and supporting information"/> <definition value="Exceptions, special conditions and supporting information applicable for this service or product."/> <requirements value="Need to reference the supporting information items that relate directly to this product or service."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.informationSequence"/> <min value="0"/> <max value="*"/> </base> <type> <code value="positiveInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.revenue"> <path value="Claim.item.revenue"/> <short value="Revenue or cost center code"/> <definition value="The type of revenue or cost center providing the product and/or service."/> <requirements value="Needed in the processing of institutional claims."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.revenue"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="RevenueCenter"/> </extension> <strength value="example"/> <description value="Codes for the revenue or cost centers supplying the service and/or products."/> <valueSet value="http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0"/> </binding> </element> <element id="Claim.item.category"> <path value="Claim.item.category"/> <short value="Benefit classification"/> <definition value="Code to identify the general type of benefits under which products and services are provided."/> <comment value="Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage."/> <requirements value="Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.category"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BenefitCategory"/> </extension> <strength value="example"/> <description value="Benefit categories such as: oral-basic, major, glasses."/> <valueSet value="http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0"/> </binding> </element> <element id="Claim.item.productOrService"> <path value="Claim.item.productOrService"/> <short value="Billing, service, product, or drug code"/> <definition value="When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used."/> <comment value="If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'."/> <requirements value="Necessary to state what was provided or done."/> <alias value="Drug Code"/> <alias value="Bill Code"/> <alias value="Service Code"/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.productOrService"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ServiceProduct"/> </extension> <strength value="example"/> <description value="Allowable service and product codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/service-uscls|5.0.0"/> </binding> </element> <element id="Claim.item.productOrServiceEnd"> <path value="Claim.item.productOrServiceEnd"/> <short value="End of a range of codes"/> <definition value="This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims."/> <alias value="End of a range of Drug Code; Bill Code; Service Cod"/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.productOrServiceEnd"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ServiceProduct"/> </extension> <strength value="example"/> <valueSet value="http://hl7.org/fhir/ValueSet/service-uscls|5.0.0"/> </binding> </element> <element id="Claim.item.request"> <path value="Claim.item.request"/> <short value="Request or Referral for Service"/> <definition value="Request or Referral for Goods or Service to be rendered."/> <requirements value="May identify the service to be provided or provider authorization for the service."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.request"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/DeviceRequest|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/ServiceRequest|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/SupplyRequest|5.0.0"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/VisionPrescription|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.modifier"> <path value="Claim.item.modifier"/> <short value="Product or service billing modifiers"/> <definition value="Item typification or modifiers codes to convey additional context for the product or service."/> <comment value="For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours."/> <requirements value="To support inclusion of the item for adjudication or to charge an elevated fee."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.modifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Modifiers"/> </extension> <strength value="example"/> <description value="Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen."/> <valueSet value="http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0"/> </binding> </element> <element id="Claim.item.programCode"> <path value="Claim.item.programCode"/> <short value="Program the product or service is provided under"/> <definition value="Identifies the program under which this may be recovered."/> <comment value="For example: Neonatal program, child dental program or drug users recovery program."/> <requirements value="Commonly used in in the identification of publicly provided program focused on population segments or disease classifications."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.programCode"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ProgramCode"/> </extension> <strength value="example"/> <description value="Program specific reason codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0"/> </binding> </element> <element id="Claim.item.serviced[x]"> <path value="Claim.item.serviced[x]"/> <short value="Date or dates of service or product delivery"/> <definition value="The date or dates when the service or product was supplied, performed or completed."/> <requirements value="Needed to determine whether the service or product was provided during the term of the insurance coverage."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.serviced[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="date"/> </type> <type> <code value="Period"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="w5"/> <map value="FiveWs.done[x]"/> </mapping> </element> <element id="Claim.item.location[x]"> <path value="Claim.item.location[x]"/> <short value="Place of service or where product was supplied"/> <definition value="Where the product or service was provided."/> <requirements value="The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.location[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <type> <code value="Address"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Location|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ServicePlace"/> </extension> <strength value="example"/> <description value="Place of service: pharmacy, school, prison, etc."/> <valueSet value="http://hl7.org/fhir/ValueSet/service-place|5.0.0"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.where[x]"/> </mapping> </element> <element id="Claim.item.patientPaid"> <path value="Claim.item.patientPaid"/> <short value="Paid by the patient"/> <definition value="The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services."/> <requirements value="Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.patientPaid"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Money"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.quantity"> <path value="Claim.item.quantity"/> <short value="Count of products or services"/> <definition value="The number of repetitions of a service or product."/> <requirements value="Required when the product or service code does not convey the quantity provided."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.quantity"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.unitPrice"> <path value="Claim.item.unitPrice"/> <short value="Fee, charge or cost per item"/> <definition value="If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group."/> <requirements value="The amount charged to the patient by the provider for a single unit."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.unitPrice"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Money"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.factor"> <path value="Claim.item.factor"/> <short value="Price scaling factor"/> <definition value="A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount."/> <comment value="To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)."/> <requirements value="When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.factor"/> <min value="0"/> <max value="1"/> </base> <type> <code value="decimal"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.tax"> <path value="Claim.item.tax"/> <short value="Total tax"/> <definition value="The total of taxes applicable for this product or service."/> <requirements value="Required when taxes are not embedded in the unit price or provided as a separate service."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.tax"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Money"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.net"> <path value="Claim.item.net"/> <short value="Total item cost"/> <definition value="The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor."/> <comment value="For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied."/> <requirements value="Provides the total amount claimed for the group (if a grouper) or the line item."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.net"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Money"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.udi"> <path value="Claim.item.udi"/> <short value="Unique device identifier"/> <definition value="Unique Device Identifiers associated with this line item."/> <requirements value="The UDI code allows the insurer to obtain device level information on the product supplied."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.udi"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.bodySite"> <path value="Claim.item.bodySite"/> <short value="Anatomical location"/> <definition value="Physical location where the service is performed or applies."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.bodySite"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.bodySite.id"> <path value="Claim.item.bodySite.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.item.bodySite.extension"> <path value="Claim.item.bodySite.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.item.bodySite.modifierExtension"> <path value="Claim.item.bodySite.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.item.bodySite.site"> <path value="Claim.item.bodySite.site"/> <short value="Location"/> <definition value="Physical service site on the patient (limb, tooth, etc.)."/> <comment value="For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed."/> <requirements value="Allows insurer to validate specific procedures."/> <min value="1"/> <max value="*"/> <base> <path value="Claim.item.bodySite.site"/> <min value="1"/> <max value="*"/> </base> <type> <code value="CodeableReference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/BodyStructure|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="OralSites"/> </extension> <strength value="example"/> <valueSet value="http://hl7.org/fhir/ValueSet/tooth|5.0.0"/> </binding> </element> <element id="Claim.item.bodySite.subSite"> <path value="Claim.item.bodySite.subSite"/> <short value="Sub-location"/> <definition value="A region or surface of the bodySite, e.g. limb region or tooth surface(s)."/> <requirements value="Allows insurer to validate specific procedures."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.bodySite.subSite"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Surface"/> </extension> <strength value="example"/> <valueSet value="http://hl7.org/fhir/ValueSet/surface|5.0.0"/> </binding> </element> <element id="Claim.item.encounter"> <path value="Claim.item.encounter"/> <short value="Encounters associated with the listed treatments"/> <definition value="Healthcare encounters related to this claim."/> <comment value="This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter."/> <requirements value="Used in some jurisdictions to link clinical events to claim items."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.encounter"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Encounter|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Request.context"/> </mapping> </element> <element id="Claim.item.detail"> <path value="Claim.item.detail"/> <short value="Product or service provided"/> <definition value="A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items."/> <requirements value="The items to be processed for adjudication."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.detail"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.id"> <path value="Claim.item.detail.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.item.detail.extension"> <path value="Claim.item.detail.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.item.detail.modifierExtension"> <path value="Claim.item.detail.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.item.detail.sequence"> <path value="Claim.item.detail.sequence"/> <short value="Item instance identifier"/> <definition value="A number to uniquely identify item entries."/> <requirements value="Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.item.detail.sequence"/> <min value="1"/> <max value="1"/> </base> <type> <code value="positiveInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.traceNumber"> <path value="Claim.item.detail.traceNumber"/> <short value="Number for tracking"/> <definition value="Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners."/> <requirements value="Allows partners to uniquely identify components for tracking."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.detail.traceNumber"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.revenue"> <path value="Claim.item.detail.revenue"/> <short value="Revenue or cost center code"/> <definition value="The type of revenue or cost center providing the product and/or service."/> <requirements value="Needed in the processing of institutional claims."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.revenue"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="RevenueCenter"/> </extension> <strength value="example"/> <description value="Codes for the revenue or cost centers supplying the service and/or products."/> <valueSet value="http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0"/> </binding> </element> <element id="Claim.item.detail.category"> <path value="Claim.item.detail.category"/> <short value="Benefit classification"/> <definition value="Code to identify the general type of benefits under which products and services are provided."/> <comment value="Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage."/> <requirements value="Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.category"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BenefitCategory"/> </extension> <strength value="example"/> <description value="Benefit categories such as: oral-basic, major, glasses."/> <valueSet value="http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0"/> </binding> </element> <element id="Claim.item.detail.productOrService"> <path value="Claim.item.detail.productOrService"/> <short value="Billing, service, product, or drug code"/> <definition value="When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used."/> <comment value="If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'."/> <requirements value="Necessary to state what was provided or done."/> <alias value="Drug Code"/> <alias value="Bill Code"/> <alias value="Service Code"/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.productOrService"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ServiceProduct"/> </extension> <strength value="example"/> <description value="Allowable service and product codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/service-uscls|5.0.0"/> </binding> </element> <element id="Claim.item.detail.productOrServiceEnd"> <path value="Claim.item.detail.productOrServiceEnd"/> <short value="End of a range of codes"/> <definition value="This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims."/> <alias value="End of a range of Drug Code; Bill Code; Service Cod"/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.productOrServiceEnd"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ServiceProduct"/> </extension> <strength value="example"/> <valueSet value="http://hl7.org/fhir/ValueSet/service-uscls|5.0.0"/> </binding> </element> <element id="Claim.item.detail.modifier"> <path value="Claim.item.detail.modifier"/> <short value="Service/Product billing modifiers"/> <definition value="Item typification or modifiers codes to convey additional context for the product or service."/> <comment value="For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours."/> <requirements value="To support inclusion of the item for adjudication or to charge an elevated fee."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.detail.modifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Modifiers"/> </extension> <strength value="example"/> <description value="Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen."/> <valueSet value="http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0"/> </binding> </element> <element id="Claim.item.detail.programCode"> <path value="Claim.item.detail.programCode"/> <short value="Program the product or service is provided under"/> <definition value="Identifies the program under which this may be recovered."/> <comment value="For example: Neonatal program, child dental program or drug users recovery program."/> <requirements value="Commonly used in in the identification of publicly provided program focused on population segments or disease classifications."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.detail.programCode"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ProgramCode"/> </extension> <strength value="example"/> <description value="Program specific reason codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0"/> </binding> </element> <element id="Claim.item.detail.patientPaid"> <path value="Claim.item.detail.patientPaid"/> <short value="Paid by the patient"/> <definition value="The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services."/> <requirements value="Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.patientPaid"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Money"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.quantity"> <path value="Claim.item.detail.quantity"/> <short value="Count of products or services"/> <definition value="The number of repetitions of a service or product."/> <requirements value="Required when the product or service code does not convey the quantity provided."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.quantity"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.unitPrice"> <path value="Claim.item.detail.unitPrice"/> <short value="Fee, charge or cost per item"/> <definition value="If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group."/> <requirements value="The amount charged to the patient by the provider for a single unit."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.unitPrice"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Money"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.factor"> <path value="Claim.item.detail.factor"/> <short value="Price scaling factor"/> <definition value="A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount."/> <comment value="To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)."/> <requirements value="When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.factor"/> <min value="0"/> <max value="1"/> </base> <type> <code value="decimal"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.tax"> <path value="Claim.item.detail.tax"/> <short value="Total tax"/> <definition value="The total of taxes applicable for this product or service."/> <requirements value="Required when taxes are not embedded in the unit price or provided as a separate service."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.tax"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Money"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.net"> <path value="Claim.item.detail.net"/> <short value="Total item cost"/> <definition value="The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor."/> <comment value="For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied."/> <requirements value="Provides the total amount claimed for the group (if a grouper) or the line item."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.net"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Money"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.udi"> <path value="Claim.item.detail.udi"/> <short value="Unique device identifier"/> <definition value="Unique Device Identifiers associated with this line item."/> <requirements value="The UDI code allows the insurer to obtain device level information on the product supplied."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.detail.udi"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.subDetail"> <path value="Claim.item.detail.subDetail"/> <short value="Product or service provided"/> <definition value="A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items."/> <requirements value="The items to be processed for adjudication."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.detail.subDetail"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.subDetail.id"> <path value="Claim.item.detail.subDetail.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string"/> </extension> <code value="http://hl7.org/fhirpath/System.String"/> </type> <condition value="ele-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.item.detail.subDetail.extension"> <path value="Claim.item.detail.subDetail.extension"/> <short value="Additional content defined by implementations"/> <definition value="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 managable, 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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Claim.item.detail.subDetail.modifierExtension"> <path value="Claim.item.detail.subDetail.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="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 managable, 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <constraint> <key value="ext-1"/> <severity value="error"/> <human value="Must have either extensions or value[x], not both"/> <expression value="extension.exists() != value.exists()"/> <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> </constraint> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Claim.item.detail.subDetail.sequence"> <path value="Claim.item.detail.subDetail.sequence"/> <short value="Item instance identifier"/> <definition value="A number to uniquely identify item entries."/> <requirements value="Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse."/> <min value="1"/> <max value="1"/> <base> <path value="Claim.item.detail.subDetail.sequence"/> <min value="1"/> <max value="1"/> </base> <type> <code value="positiveInt"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.subDetail.traceNumber"> <path value="Claim.item.detail.subDetail.traceNumber"/> <short value="Number for tracking"/> <definition value="Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners."/> <requirements value="Allows partners to uniquely identify components for tracking."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.detail.subDetail.traceNumber"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.subDetail.revenue"> <path value="Claim.item.detail.subDetail.revenue"/> <short value="Revenue or cost center code"/> <definition value="The type of revenue or cost center providing the product and/or service."/> <requirements value="Needed in the processing of institutional claims."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.subDetail.revenue"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="RevenueCenter"/> </extension> <strength value="example"/> <description value="Codes for the revenue or cost centers supplying the service and/or products."/> <valueSet value="http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0"/> </binding> </element> <element id="Claim.item.detail.subDetail.category"> <path value="Claim.item.detail.subDetail.category"/> <short value="Benefit classification"/> <definition value="Code to identify the general type of benefits under which products and services are provided."/> <comment value="Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage."/> <requirements value="Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.subDetail.category"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BenefitCategory"/> </extension> <strength value="example"/> <description value="Benefit categories such as: oral-basic, major, glasses."/> <valueSet value="http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0"/> </binding> </element> <element id="Claim.item.detail.subDetail.productOrService"> <path value="Claim.item.detail.subDetail.productOrService"/> <short value="Billing, service, product, or drug code"/> <definition value="When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used."/> <comment value="If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'."/> <requirements value="Necessary to state what was provided or done."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.subDetail.productOrService"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ServiceProduct"/> </extension> <strength value="example"/> <description value="Allowable service and product codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/service-uscls|5.0.0"/> </binding> </element> <element id="Claim.item.detail.subDetail.productOrServiceEnd"> <path value="Claim.item.detail.subDetail.productOrServiceEnd"/> <short value="End of a range of codes"/> <definition value="This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims."/> <alias value="End of a range of Drug Code; Bill Code; Service Cod"/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.subDetail.productOrServiceEnd"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ServiceProduct"/> </extension> <strength value="example"/> <valueSet value="http://hl7.org/fhir/ValueSet/service-uscls|5.0.0"/> </binding> </element> <element id="Claim.item.detail.subDetail.modifier"> <path value="Claim.item.detail.subDetail.modifier"/> <short value="Service/Product billing modifiers"/> <definition value="Item typification or modifiers codes to convey additional context for the product or service."/> <comment value="For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours."/> <requirements value="To support inclusion of the item for adjudication or to charge an elevated fee."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.detail.subDetail.modifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Modifiers"/> </extension> <strength value="example"/> <description value="Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen."/> <valueSet value="http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0"/> </binding> </element> <element id="Claim.item.detail.subDetail.programCode"> <path value="Claim.item.detail.subDetail.programCode"/> <short value="Program the product or service is provided under"/> <definition value="Identifies the program under which this may be recovered."/> <comment value="For example: Neonatal program, child dental program or drug users recovery program."/> <requirements value="Commonly used in in the identification of publicly provided program focused on population segments or disease classifications."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.detail.subDetail.programCode"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ProgramCode"/> </extension> <strength value="example"/> <description value="Program specific reason codes."/> <valueSet value="http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0"/> </binding> </element> <element id="Claim.item.detail.subDetail.patientPaid"> <path value="Claim.item.detail.subDetail.patientPaid"/> <short value="Paid by the patient"/> <definition value="The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services."/> <requirements value="Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.subDetail.patientPaid"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Money"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.subDetail.quantity"> <path value="Claim.item.detail.subDetail.quantity"/> <short value="Count of products or services"/> <definition value="The number of repetitions of a service or product."/> <requirements value="Required when the product or service code does not convey the quantity provided."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.subDetail.quantity"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Quantity"/> <profile value="http://hl7.org/fhir/StructureDefinition/SimpleQuantity|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.subDetail.unitPrice"> <path value="Claim.item.detail.subDetail.unitPrice"/> <short value="Fee, charge or cost per item"/> <definition value="If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group."/> <requirements value="The amount charged to the patient by the provider for a single unit."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.subDetail.unitPrice"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Money"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.subDetail.factor"> <path value="Claim.item.detail.subDetail.factor"/> <short value="Price scaling factor"/> <definition value="A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount."/> <comment value="To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10)."/> <requirements value="When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.subDetail.factor"/> <min value="0"/> <max value="1"/> </base> <type> <code value="decimal"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.subDetail.tax"> <path value="Claim.item.detail.subDetail.tax"/> <short value="Total tax"/> <definition value="The total of taxes applicable for this product or service."/> <requirements value="Required when taxes are not embedded in the unit price or provided as a separate service."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.subDetail.tax"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Money"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.subDetail.net"> <path value="Claim.item.detail.subDetail.net"/> <short value="Total item cost"/> <definition value="The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor."/> <comment value="For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied."/> <requirements value="Provides the total amount claimed for the group (if a grouper) or the line item."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.item.detail.subDetail.net"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Money"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.item.detail.subDetail.udi"> <path value="Claim.item.detail.subDetail.udi"/> <short value="Unique device identifier"/> <definition value="Unique Device Identifiers associated with this line item."/> <requirements value="The UDI code allows the insurer to obtain device level information on the product supplied."/> <min value="0"/> <max value="*"/> <base> <path value="Claim.item.detail.subDetail.udi"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Device|5.0.0"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Claim.total"> <path value="Claim.total"/> <short value="Total claim cost"/> <definition value="The total value of the all the items in the claim."/> <requirements value="Used for control total purposes."/> <min value="0"/> <max value="1"/> <base> <path value="Claim.total"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Money"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <source value="http://hl7.org/fhir/StructureDefinition/Element"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> </snapshot> <differential> <element id="Claim.type"> <path value="Claim.type"/> <patternCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/claim-type"/> <code value="institutional"/> </coding> </patternCodeableConcept> </element> <element id="Claim.use"> <path value="Claim.use"/> <patternCode value="preauthorization"/> </element> <element id="Claim.patient"> <path value="Claim.patient"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.at/fhir/HL7ATCoreProfiles/5.0.0/StructureDefinition/at-core-patient"/> </type> </element> <element id="Claim.insurer"> <path value="Claim.insurer"/> <min value="1"/> <type> <code value="Reference"/> <targetProfile value="https://elga.moped.at/StructureDefinition/SVOrganization"/> </type> </element> <element id="Claim.provider"> <path value="Claim.provider"/> <min value="1"/> <type> <code value="Reference"/> <targetProfile value="https://elga.moped.at/StructureDefinition/KHOrganization"/> </type> </element> <element id="Claim.related.claim"> <path value="Claim.related.claim"/> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-hierarchy"> <valueBoolean value="false"/> </extension> <code value="Reference"/> <targetProfile value="https://elga.moped.at/StructureDefinition/MopedVAERequest"/> </type> </element> <element id="Claim.encounter"> <path value="Claim.encounter"/> <slicing> <discriminator> <type value="profile"/> <path value="resolve()"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> <min value="1"/> </element> <element id="Claim.encounter:MopedEncounter"> <path value="Claim.encounter"/> <sliceName value="MopedEncounter"/> <short value="Generelle Informationen zu Aufnahme und Entlassung des Patienten"/> <min value="1"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="https://elga.moped.at/StructureDefinition/MopedEncounter"/> </type> </element> <element id="Claim.encounter:TransferEncounter"> <path value="Claim.encounter"/> <sliceName value="TransferEncounter"/> <short value="Informationen zu Verlegungen innerhalb oder zwischen Krankenanstalten"/> <min value="0"/> <max value="*"/> <type> <code value="Reference"/> <targetProfile value="https://elga.moped.at/StructureDefinition/MopedTransferEncounter"/> </type> </element> <element id="Claim.supportingInfo"> <path value="Claim.supportingInfo"/> <slicing> <discriminator> <type value="value"/> <path value="category"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> <min value="1"/> </element> <element id="Claim.supportingInfo.code.coding"> <path value="Claim.supportingInfo.code.coding"/> <binding> <strength value="required"/> <valueSet value="https://elga.moped.at/ValueSet/VAESupportingInformationCategoryVS"/> </binding> </element> <element id="Claim.supportingInfo:Sonderklasse"> <path value="Claim.supportingInfo"/> <sliceName value="Sonderklasse"/> <short value="Allgemeine Gebührenklasse/Sonderklasse"/> <min value="0"/> <max value="*"/> </element> <element id="Claim.supportingInfo:Sonderklasse.category"> <path value="Claim.supportingInfo.category"/> <patternCodeableConcept> <coding> <system value="https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS"/> <code value="KLAS"/> </coding> </patternCodeableConcept> </element> <element id="Claim.supportingInfo:Sonderklasse.code"> <path value="Claim.supportingInfo.code"/> <min value="1"/> <binding> <strength value="required"/> <valueSet value="https://elga.moped.at/ValueSet/SonderklasseVS"/> </binding> </element> <element id="Claim.supportingInfo:Sonderklasse.timing[x]"> <path value="Claim.supportingInfo.timing[x]"/> <slicing> <discriminator> <type value="type"/> <path value="$this"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> <min value="1"/> </element> <element id="Claim.supportingInfo:Sonderklasse.timing[x]:timingPeriod"> <path value="Claim.supportingInfo.timing[x]"/> <sliceName value="timingPeriod"/> <min value="1"/> <max value="1"/> <type> <code value="Period"/> </type> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden"> <path value="Claim.supportingInfo"/> <sliceName value="VerdachtFremdverschulden"/> <short value="Verdacht auf Fremdversschluden"/> <min value="1"/> <max value="1"/> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden.category"> <path value="Claim.supportingInfo.category"/> <patternCodeableConcept> <coding> <system value="https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS"/> <code value="FREVER"/> </coding> </patternCodeableConcept> </element> <element id="Claim.supportingInfo:VerdachtFremdverschulden.value[x]"> <path value="Claim.supportingInfo.value[x]"/> <min value="1"/> <type> <code value="boolean"/> </type> </element> <element id="Claim.supportingInfo:Verlaengerungstage"> <path value="Claim.supportingInfo"/> <sliceName value="Verlaengerungstage"/> <short value="Anzahl der Verlängerungstage"/> <min value="0"/> <max value="1"/> </element> <element id="Claim.supportingInfo:Verlaengerungstage.category"> <path value="Claim.supportingInfo.category"/> <patternCodeableConcept> <coding> <system value="https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS"/> <code value="VERLAENG"/> </coding> </patternCodeableConcept> </element> <element id="Claim.supportingInfo:Verlaengerungstage.value[x]"> <path value="Claim.supportingInfo.value[x]"/> <slicing> <discriminator> <type value="type"/> <path value="$this"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> </element> <element id="Claim.supportingInfo:Verlaengerungstage.value[x]:valueQuantity"> <path value="Claim.supportingInfo.value[x]"/> <sliceName value="valueQuantity"/> <min value="0"/> <max value="1"/> <type> <code value="Quantity"/> </type> </element> <element id="Claim.supportingInfo:Verlaengerungstage.value[x]:valueQuantity.value"> <path value="Claim.supportingInfo.value[x].value"/> <short value="Verlängerungstage"/> <min value="1"/> </element> <element id="Claim.supportingInfo:Verlaengerungstage.value[x]:valueQuantity.unit"> <path value="Claim.supportingInfo.value[x].unit"/> <patternString value="day"/> </element> <element id="Claim.supportingInfo:Verlaengerungstage.value[x]:valueQuantity.system"> <path value="Claim.supportingInfo.value[x].system"/> <patternUri value="http://unitsofmeasure.org"/> </element> <element id="Claim.supportingInfo:Verlaengerungstage.value[x]:valueQuantity.code"> <path value="Claim.supportingInfo.value[x].code"/> <patternCode value="day"/> </element> <element id="Claim.diagnosis.onAdmission"> <path value="Claim.diagnosis.onAdmission"/> <definition value="Gibt an ob die Diagnose bereits bei Aufnahme in den stationären Aufenthalt vorhanden war"/> </element> <element id="Claim.insurance.coverage"> <path value="Claim.insurance.coverage"/> <type> <code value="Reference"/> <targetProfile value="https://elga.moped.at/StructureDefinition/MopedCoverage"/> </type> </element> <element id="Claim.accident.type"> <path value="Claim.accident.type"/> <short value="Verdacht auf Fremdversschluden"/> <min value="1"/> <binding> <strength value="required"/> <valueSet value="https://elga.moped.at/ValueSet/VerdachtArbeitsSchuelerunfallVS"/> </binding> </element> </differential> </StructureDefinition>

Generated Narrative: StructureDefinition MopedVAERequest

Name	Card.	Type	Description & Constraints
Claim		Claim
type	1..1	CodeableConcept	Category or discipline Required Pattern: At least the following
coding	1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
code	1..1	code	Symbol in syntax defined by the system Fixed Value: institutional
use	1..1	code	claim \| preauthorization \| predetermination Required Pattern: preauthorization
patient	1..1	Reference(HL7® AT Core Patient Profile)	The recipient of the products and services
insurer	1..1	Reference(SV Organization)	Target
provider	1..1	Reference(KH Organization)	Party responsible for the claim
related
claim	0..1	Reference(MOPED VAERequest)	Reference to the related claim
Slices for encounter	1..*	Reference(Encounter)	Encounters associated with the listed treatments Slice: Unordered, Open by profile:resolve()
encounter:MopedEncounter	1..1	Reference(MOPED Encounter)	Generelle Informationen zu Aufnahme und Entlassung des Patienten
encounter:TransferEncounter	0..*	Reference(MOPED TransferEncounter)	Informationen zu Verlegungen innerhalb oder zwischen Krankenanstalten
Slices for supportingInfo	1..*	BackboneElement	Supporting information Slice: Unordered, Open by value:category
supportingInfo:All Slices			Content/Rules for all slices
code
coding	0..*	Coding	Code defined by a terminology system Binding: MOPED VAESupportingInformationCategory (required)
supportingInfo:Sonderklasse	0..*	BackboneElement	Allgemeine Gebührenklasse/Sonderklasse
category	1..1	CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding	1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system	1..1	uri	Identity of the terminology system Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
code	1..1	code	Symbol in syntax defined by the system Fixed Value: KLAS
code	1..1	CodeableConcept	Type of information Binding: Sonderklasse ValueSet (required)
Slices for timing[x]	1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod	1..1	Period	When it occurred
supportingInfo:VerdachtFremdverschulden	1..1	BackboneElement	Verdacht auf Fremdversschluden
category	1..1	CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding	1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system	1..1	uri	Identity of the terminology system Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
code	1..1	code	Symbol in syntax defined by the system Fixed Value: FREVER
value[x]	1..1	boolean	Data to be provided
supportingInfo:Verlaengerungstage	0..1	BackboneElement	Anzahl der Verlängerungstage
category	1..1	CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding	1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system	1..1	uri	Identity of the terminology system Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
code	1..1	code	Symbol in syntax defined by the system Fixed Value: VERLAENG
Slices for value[x]	0..1	boolean, string, Quantity, Attachment, Reference(Resource), Identifier	Data to be provided Slice: Unordered, Open by type:$this
value[x]:valueQuantity	0..1	Quantity	Data to be provided
value	1..1	decimal	Verlängerungstage
unit	0..1	string	Unit representation Required Pattern: day
system	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	0..1	code	Coded form of the unit Required Pattern: day
diagnosis
onAdmission	0..1	CodeableConcept	Present on admission
insurance
coverage	1..1	Reference(MOPED Coverage)	Insurance information
accident
type	1..1	CodeableConcept	Verdacht auf Fremdversschluden Binding: Verdacht auf Arbeits- oder Schuelerunfall ValueSet (required)
Documentation for this format