Moderne Patient:innenabrechnung und Datenkommunikation on FHIR (MOPED)
0.1.0 - ci-build

Moderne Patient:innenabrechnung und Datenkommunikation on FHIR (MOPED) - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: MopedLKFRequest - Detailed Descriptions

Draft as of 2025-07-11

Definitions for the MopedLKFRequest resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Claim
Definition

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.

ShortClaim, Pre-determination or Pre-authorization
Comments

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.

Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate NamesAdjudication Request, Preauthorization Request, Predetermination Request
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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 (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())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Claim.implicitRules
Definition

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.

ShortA set of rules under which this content was created
Comments

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.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Claim.contained
Definition

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.

ShortContained, inline Resources
Comments

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.

Control0..*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
6. Claim.extension
Definition

An Extension


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.

ShortExtensionAdditional content defined by implementations
Comments

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.

Control10..*
TypeExtension
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Claim.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. Claim.extension:DiagnoseKnoten
    Slice NameDiagnoseKnoten
    Definition

    "Abrechnung - Knoten:" Lukriert die Patient:innen über eine reguläre Gruppe Punkte, so ist in diesem Datenfeld die entsprechende Knotenbezeichnung einzutragen.

    Short"Abrechnung - Knoten:" Lukriert die Patient:innen über eine reguläre Gruppe Punkte, so ist in diesem Datenfeld die entsprechende Knotenbezeichnung einzutragen.
    Control1..1
    TypeExtension(Abrechnung - Knoten) (Extension Type: Coding)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. Claim.extension:FehlerWarnung
    Slice NameFehlerWarnung
    Definition

    MOPED Extension für akzeptierte Errors und Warnings

    ShortError/Warning
    Control0..*
    TypeExtension(Error/Warning) (Complex Extension)
    Is Modifierfalse
    Must Supportfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Claim.modifierExtension
    Definition

    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).

    ShortExtensions that cannot be ignored
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Must Supportfalse
    Summarytrue
    Requirements

    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.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. Claim.status
    Definition

    The status of the resource instance.

    Shortactive | cancelled | draft | entered-in-error
    Comments

    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

    Control1..1
    BindingThe codes SHALL be taken from FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|5.0.0
    (required to http://hl7.org/fhir/ValueSet/fm-status|5.0.0)

    A code specifying the state of the resource instance.

    Typecode
    Is Modifiertrue because 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
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Requirements

    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'.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. Claim.type
    Definition

    The category of claim, e.g. oral, pharmacy, vision, institutional, professional.

    ShortCategory or discipline
    Comments

    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.

    Control1..1
    BindingUnless not suitable, these codes SHALL be taken from ClaimTypeCodeshttp://hl7.org/fhir/ValueSet/claim-type
    (extensible to http://hl7.org/fhir/ValueSet/claim-type)

    The type or discipline-style of the claim.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Requirements

    Claim type determine the general sets of business rules applied for information requirements and adjudication.

    Pattern Value{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
        "code" : "institutional"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Claim.use
    Definition

    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.

    Shortclaim | preauthorization | predetermination
    Control1..1
    BindingThe codes SHALL be taken from Usehttp://hl7.org/fhir/ValueSet/claim-use|5.0.0
    (required to http://hl7.org/fhir/ValueSet/claim-use|5.0.0)

    The purpose of the Claim: predetermination, preauthorization, claim.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Requirements

    This element is required to understand the nature of the request for adjudication.

    Pattern Valueclaim
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. Claim.patient
    Definition

    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.

    ShortThe recipient of the products and services
    Control1..1
    TypeReference(HL7® AT Core Patient Profile, Patient)
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Requirements

    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.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. Claim.created
    Definition

    The date this resource was created.

    ShortResource creation date
    Comments

    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.

    Control1..1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Requirements

    Need to record a timestamp for use by both the recipient and the issuer.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Claim.insurer
    Definition

    The Insurer who is target of the request.

    ShortTarget
    Control10..1
    TypeReference(SV Organization, Organization)
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Claim.provider
    Definition

    The provider which is responsible for the claim, predetermination or preauthorization.

    ShortParty responsible for the claim
    Comments

    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.

    Control10..1
    TypeReference(KH Organization, Practitioner, PractitionerRole, Organization)
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. Claim.encounter
    Definition

    Healthcare encounters related to this claim.

    ShortEncounters associated with the listed treatments
    Comments

    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.

    Control20..*
    TypeReference(Encounter)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Requirements

    Used in some jurisdictions to link clinical events to claim items.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on Claim.encounter. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • profile @ resolve()
    • 30. Claim.encounter:MopedEncounter
      Slice NameMopedEncounter
      Definition

      Healthcare encounters related to this claim.

      ShortGenerelle Informationen zu Aufnahme und Entlassung des PatientenEncounters associated with the listed treatments
      Comments

      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.

      Control10..1*
      TypeReference(MOPED Encounter, Encounter)
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Requirements

      Used in some jurisdictions to link clinical events to claim items.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. Claim.encounter:TransferEncounter
      Slice NameTransferEncounter
      Definition

      Healthcare encounters related to this claim.

      ShortInformationen zu Verlegungen innerhalb oder zwischen KrankenanstaltenEncounters associated with the listed treatments
      Comments

      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.

      Control10..*
      TypeReference(MOPED TransferEncounter, Encounter)
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Requirements

      Used in some jurisdictions to link clinical events to claim items.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. Claim.diagnosisRelatedGroup
      Definition

      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.

      Short"Abrechnung - Gruppe:" Dieses Datenfeld ist mit der Codenummer der zutreffenden Abrechnungsgruppe zu befüllen. Bei Datensätzen von stationären Krankenhausaufenthalten, die keiner leistungsorientier- ten Diagnosenfallgruppe zugeordnet werden, erfolgt ein Eintrag entsprechend der jeweiligen Aufnahmeart.Package billing code
      Comments

      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.

      Control10..1
      BindingThe codes SHALL be taken from For example codes, see LKF Abrechnungsgruppehttp://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup
      (required to https://elga.moped.at/ValueSet/LKFAbrechnungsGruppeVS)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Requirements

      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.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Claim.supportingInfo
      Definition

      Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.

      ShortSupporting information
      Comments

      Often there are multiple jurisdiction specific valuesets which are required.

      Control10..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Requirements

      Typically these information codes are required to support the services rendered or the adjudication of the services rendered.

      Alternate NamesAttachments Exception Codes Occurrence Codes Value codes
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Claim.supportingInfo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ category
      • 38. Claim.supportingInfo.modifierExtension
        Definition

        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).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        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.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        40. Claim.supportingInfo.sequence
        Definition

        A number to uniquely identify supporting information entries.

        ShortInformation instance identifier
        Control1..1
        TypepositiveInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Requirements

        Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. Claim.supportingInfo.category
        Definition

        The general class of the information supplied: information; exception; accident, employment; onset, etc.

        ShortClassification of the supplied information
        Comments

        This may contain a category for the local bill type codes.

        Control1..1
        BindingFor example codes, see ClaimInformationCategoryCodeshttp://hl7.org/fhir/ValueSet/claim-informationcategory
        (example to http://hl7.org/fhir/ValueSet/claim-informationcategory)

        The valuset used for additional information category codes.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Requirements

        Required to group or associate information items with common characteristics. For example: admission information or prior treatments.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. Claim.supportingInfo:Plausibilitaetskennzeichen
        Slice NamePlausibilitaetskennzeichen
        Definition

        Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.

        ShortPlausibilitätskennzeichen - Dieses Datenfeld enthält eine Kennzeichnung als Ergebnis der vom Gesundheitsministerium vorgegebenen Plausibilitätsprüfung.Supporting information
        Comments

        Often there are multiple jurisdiction specific valuesets which are required.

        Control10..1*
        TypeBackboneElement
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Requirements

        Typically these information codes are required to support the services rendered or the adjudication of the services rendered.

        Alternate NamesAttachments Exception Codes Occurrence Codes Value codes
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. Claim.supportingInfo:Plausibilitaetskennzeichen.modifierExtension
        Definition

        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).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        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.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        48. Claim.supportingInfo:Plausibilitaetskennzeichen.sequence
        Definition

        A number to uniquely identify supporting information entries.

        ShortInformation instance identifier
        Control1..1
        TypepositiveInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Requirements

        Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. Claim.supportingInfo:Plausibilitaetskennzeichen.category
        Definition

        The general class of the information supplied: information; exception; accident, employment; onset, etc.

        ShortClassification of the supplied information
        Comments

        This may contain a category for the local bill type codes.

        Control1..1
        BindingFor example codes, see ClaimInformationCategoryCodeshttp://hl7.org/fhir/ValueSet/claim-informationcategory
        (example to http://hl7.org/fhir/ValueSet/claim-informationcategory)

        The valuset used for additional information category codes.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Requirements

        Required to group or associate information items with common characteristics. For example: admission information or prior treatments.

        Pattern Value{
          "coding" : [{
            "system" : "https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS",
            "code" : "PLAUS"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Claim.supportingInfo:Plausibilitaetskennzeichen.value[x]
        Definition

        Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.

        ShortData to be provided
        Comments

        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.

        Control0..1
        Typestring, boolean, Identifier, Reference(Resource), Quantity, Attachment
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Requirements

        To convey the data content to be provided when the information is more than a simple code or period.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. Claim.diagnosis
        Definition

        Information about diagnoses relevant to the claim items.

        ShortPertinent diagnosis information
        Control10..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Requirements

        Required for the adjudication by provided context for the services and product listed.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Claim.diagnosis. The slices areOrdered and Open, and can be differentiated using the following discriminators:
        • value @ type.coding
        • 56. Claim.diagnosis.modifierExtension
          Definition

          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).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          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.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          58. Claim.diagnosis.sequence
          Definition

          A number to uniquely identify diagnosis entries.

          ShortDiagnosis instance identifier
          Comments

          Diagnosis are presented in list order to their expected importance: primary, secondary, etc.

          Control1..1
          TypepositiveInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Requirements

          Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          60. Claim.diagnosis.diagnosis[x]
          Definition

          The nature of illness or problem in a coded form or as a reference to an external defined Condition.

          ShortNature of illness or problem
          Control1..1
          BindingFor example codes, see ICD10Codeshttp://hl7.org/fhir/ValueSet/icd-10
          (example to http://hl7.org/fhir/ValueSet/icd-10)

          Example ICD10 Diagnostic codes.

          TypeChoice of: CodeableConcept, Reference(Condition)
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Requirements

          Provides health context for the evaluation of the products and/or services.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. Claim.diagnosis:Hauptdiagnose
          Slice NameHauptdiagnose
          Definition

          Information about diagnoses relevant to the claim items.

          ShortPertinent diagnosis information
          Control10..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Requirements

          Required for the adjudication by provided context for the services and product listed.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. Claim.diagnosis:Hauptdiagnose.modifierExtension
          Definition

          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).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          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.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          66. Claim.diagnosis:Hauptdiagnose.sequence
          Definition

          A number to uniquely identify diagnosis entries.

          ShortDiagnosis instance identifier
          Comments

          Diagnosis are presented in list order to their expected importance: primary, secondary, etc.

          Control1..1
          TypepositiveInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Requirements

          Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. Claim.diagnosis:Hauptdiagnose.diagnosis[x]
          Definition

          The nature of illness or problem in a coded form or as a reference to an external defined Condition.

          ShortNature of illness or problem
          Control1..1
          TypeReference(MOPED Condition, Condition), CodeableConcept
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Requirements

          Provides health context for the evaluation of the products and/or services.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. Claim.diagnosis:Hauptdiagnose.type
          Definition

          When the condition was observed or the relative ranking.

          ShortTiming or nature of the diagnosis
          Comments

          For example: admitting, primary, secondary, discharge.

          Control0..*
          BindingFor example codes, see ExampleDiagnosisTypeCodeshttp://hl7.org/fhir/ValueSet/ex-diagnosistype
          (example to http://hl7.org/fhir/ValueSet/ex-diagnosistype)

          Code für den Typ der LKF Diagnose, der angibt ob es sich um eine Haupt- oder Nebendiagnose handelt


          The type of the diagnosis: admitting, principal, discharge.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Requirements

          Often required to capture a particular diagnosis, for example: primary or discharge.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. Claim.diagnosis:Hauptdiagnose.type.coding
          Definition

          A reference to a code defined by a terminology system.

          ShortCode defined by a terminology system
          Comments

          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.

          Control10..*
          BindingThe codes SHALL be taken from For codes, see LKF Diagnosetyp ValueSet
          (required to https://elga.moped.at/ValueSet/LKFDiagnoseTypVS)
          TypeCoding
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows for alternative encodings within a code system, and translations to other code systems.

          Pattern Value{
            "system" : "https://termgit.elga.gv.at/ValueSet/lkf-diagnose-typ",
            "code" : "H"
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          74. Claim.diagnosis:Hauptdiagnose.onAdmission
          Definition

          Gibt an ob die Diagnose bereits bei Aufnahme in den stationären Aufenthalt vorhanden war


          Indication of whether the diagnosis was present on admission to a facility.

          ShortPresent on admission
          Control0..1
          BindingFor example codes, see ExampleDiagnosisOnAdmissionCodeshttp://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission
          (example to http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission)

          Present on admission.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Requirements

          Many systems need to understand for adjudication if the diagnosis was present a time of admission.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          76. Claim.diagnosis:Zusatzdiagnose
          Slice NameZusatzdiagnose
          Definition

          Information about diagnoses relevant to the claim items.

          ShortPertinent diagnosis information
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Requirements

          Required for the adjudication by provided context for the services and product listed.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          78. Claim.diagnosis:Zusatzdiagnose.modifierExtension
          Definition

          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).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          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.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          80. Claim.diagnosis:Zusatzdiagnose.sequence
          Definition

          A number to uniquely identify diagnosis entries.

          ShortDiagnosis instance identifier
          Comments

          Diagnosis are presented in list order to their expected importance: primary, secondary, etc.

          Control1..1
          TypepositiveInt
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Requirements

          Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          82. Claim.diagnosis:Zusatzdiagnose.diagnosis[x]
          Definition

          The nature of illness or problem in a coded form or as a reference to an external defined Condition.

          ShortNature of illness or problem
          Control1..1
          TypeReference(MOPED Condition, Condition), CodeableConcept
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Requirements

          Provides health context for the evaluation of the products and/or services.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          84. Claim.diagnosis:Zusatzdiagnose.type
          Definition

          When the condition was observed or the relative ranking.

          ShortTiming or nature of the diagnosis
          Comments

          For example: admitting, primary, secondary, discharge.

          Control0..*
          BindingFor example codes, see ExampleDiagnosisTypeCodeshttp://hl7.org/fhir/ValueSet/ex-diagnosistype
          (example to http://hl7.org/fhir/ValueSet/ex-diagnosistype)

          Code für den Typ der LKF Diagnose, der angibt ob es sich um eine Haupt- oder Nebendiagnose handelt


          The type of the diagnosis: admitting, principal, discharge.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Requirements

          Often required to capture a particular diagnosis, for example: primary or discharge.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          86. Claim.diagnosis:Zusatzdiagnose.type.coding
          Definition

          A reference to a code defined by a terminology system.

          ShortCode defined by a terminology system
          Comments

          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.

          Control10..*
          BindingThe codes SHALL be taken from For codes, see LKF Diagnosetyp ValueSet
          (required to https://elga.moped.at/ValueSet/LKFDiagnoseTypVS)
          TypeCoding
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows for alternative encodings within a code system, and translations to other code systems.

          Pattern Value{
            "system" : "https://termgit.elga.gv.at/ValueSet/lkf-diagnose-typ",
            "code" : "Z"
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          88. Claim.diagnosis:Zusatzdiagnose.onAdmission
          Definition

          Gibt an ob die Diagnose bereits bei Aufnahme in den stationären Aufenthalt vorhanden war


          Indication of whether the diagnosis was present on admission to a facility.

          ShortPresent on admission
          Control0..1
          BindingFor example codes, see ExampleDiagnosisOnAdmissionCodeshttp://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission
          (example to http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission)

          Present on admission.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Requirements

          Many systems need to understand for adjudication if the diagnosis was present a time of admission.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          90. Claim.item
          Definition

          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.

          ShortProduct or service provided
          Control30..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Requirements

          The items to be processed for adjudication.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Claim.item. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ category.coding
          • 92. Claim.item.modifierExtension
            Definition

            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).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            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.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            94. Claim.item.sequence
            Definition

            A number to uniquely identify item entries.

            ShortItem instance identifier
            Control1..1
            TypepositiveInt
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Requirements

            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            96. Claim.item:Leistungskomponente
            Slice NameLeistungskomponente
            Definition

            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.

            ShortProduct or service provided
            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            The items to be processed for adjudication.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            98. Claim.item:Leistungskomponente.modifierExtension
            Definition

            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).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            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.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            100. Claim.item:Leistungskomponente.sequence
            Definition

            A number to uniquely identify item entries.

            ShortItem instance identifier
            Control1..1
            TypepositiveInt
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Requirements

            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            102. Claim.item:Leistungskomponente.category
            Definition

            Code to identify the general type of benefits under which products and services are provided.

            ShortBenefit classification
            Comments

            Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

            Control0..1
            BindingThe codes SHALL be taken from For example codes, see Moped Claim Item Category ValueSethttp://hl7.org/fhir/ValueSet/ex-benefitcategory
            (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
            TypeCodeableConcept
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            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.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            104. Claim.item:Leistungskomponente.category.coding
            Definition

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

            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.

            Control10..*
            TypeCoding
            Is Modifierfalse
            Summarytrue
            Requirements

            Allows for alternative encodings within a code system, and translations to other code systems.

            Pattern Value{
              "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
              "code" : "LDFPLK"
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            106. Claim.item:Leistungskomponente.quantity
            Definition

            The number of repetitions of a service or product.

            ShortPunkteanzahlCount of products or services
            Control10..1
            TypeQuantity(SimpleQuantity)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            Required when the product or service code does not convey the quantity provided.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            108. Claim.item:Leistungskomponente.quantity.comparator
            Definition

            Not allowed to be used in this context


            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.

            Short< | <= | >= | > | ad - how to understand the value
            Control0..01
            BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0
            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

            How the Quantity should be understood and represented.

            Typecode
            Is Modifiertrue because 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
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

            Meaning if MissingIf there is no comparator, then there is no modification of the value
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            110. Claim.item:Leistungskomponente.quantity.unit
            Definition

            A human-readable form of the unit.

            ShortUnit representation
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

            Pattern ValueLKF Punkte
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            112. Claim.item:Tageskomponente
            Slice NameTageskomponente
            Definition

            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.

            ShortProduct or service provided
            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            The items to be processed for adjudication.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            114. Claim.item:Tageskomponente.modifierExtension
            Definition

            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).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            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.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            116. Claim.item:Tageskomponente.sequence
            Definition

            A number to uniquely identify item entries.

            ShortItem instance identifier
            Control1..1
            TypepositiveInt
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Requirements

            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            118. Claim.item:Tageskomponente.quantity
            Definition

            The number of repetitions of a service or product.

            ShortPunkteanzahlCount of products or services
            Control10..1
            TypeQuantity(SimpleQuantity)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            Required when the product or service code does not convey the quantity provided.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            120. Claim.item:Tageskomponente.quantity.value
            Definition

            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

            ShortNumerical value (with implicit precision)
            Comments

            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).

            Control10..1
            Typedecimal
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Precision is handled implicitly in almost all cases of measurement.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            122. Claim.item:Tageskomponente.quantity.comparator
            Definition

            Not allowed to be used in this context


            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.

            Short< | <= | >= | > | ad - how to understand the value
            Control0..01
            BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0
            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

            How the Quantity should be understood and represented.

            Typecode
            Is Modifiertrue because 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
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

            Meaning if MissingIf there is no comparator, then there is no modification of the value
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            124. Claim.item:Tageskomponente.quantity.unit
            Definition

            A human-readable form of the unit.

            ShortUnit representation
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

            Pattern ValueLKF Punkte
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            126. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente
            Slice NamePunkteBelagsdauerausreisserUntenLeistungskomponente
            Definition

            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.

            ShortProduct or service provided
            Control0..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            The items to be processed for adjudication.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            128. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.modifierExtension
            Definition

            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).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            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.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            130. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.sequence
            Definition

            A number to uniquely identify item entries.

            ShortItem instance identifier
            Control1..1
            TypepositiveInt
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Requirements

            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            132. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity
            Definition

            The number of repetitions of a service or product.

            ShortPunkteanzahlCount of products or services
            Control10..1
            TypeQuantity(SimpleQuantity)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            Required when the product or service code does not convey the quantity provided.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            134. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.value
            Definition

            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

            ShortNumerical value (with implicit precision)
            Comments

            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).

            Control10..1
            Typedecimal
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Precision is handled implicitly in almost all cases of measurement.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            136. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.comparator
            Definition

            Not allowed to be used in this context


            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.

            Short< | <= | >= | > | ad - how to understand the value
            Control0..01
            BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0
            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

            How the Quantity should be understood and represented.

            Typecode
            Is Modifiertrue because 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
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

            Meaning if MissingIf there is no comparator, then there is no modification of the value
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            138. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.unit
            Definition

            A human-readable form of the unit.

            ShortUnit representation
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

            Pattern ValueLKF Punkte
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            140. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente
            Slice NamePunkteBelagsdauerausreisserUntenTageskomponente
            Definition

            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.

            ShortProduct or service provided
            Control0..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            The items to be processed for adjudication.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            142. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.modifierExtension
            Definition

            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).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            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.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            144. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.sequence
            Definition

            A number to uniquely identify item entries.

            ShortItem instance identifier
            Control1..1
            TypepositiveInt
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Requirements

            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            146. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity
            Definition

            The number of repetitions of a service or product.

            ShortPunkteanzahlCount of products or services
            Control10..1
            TypeQuantity(SimpleQuantity)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            Required when the product or service code does not convey the quantity provided.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            148. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.value
            Definition

            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

            ShortNumerical value (with implicit precision)
            Comments

            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).

            Control10..1
            Typedecimal
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Precision is handled implicitly in almost all cases of measurement.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            150. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.comparator
            Definition

            Not allowed to be used in this context


            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.

            Short< | <= | >= | > | ad - how to understand the value
            Control0..01
            BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0
            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

            How the Quantity should be understood and represented.

            Typecode
            Is Modifiertrue because 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
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

            Meaning if MissingIf there is no comparator, then there is no modification of the value
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            152. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.unit
            Definition

            A human-readable form of the unit.

            ShortUnit representation
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

            Pattern ValueLKF Punkte
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            154. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben
            Slice NameZusatzpunkteBelagsdauerausreisserNachOben
            Definition

            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.

            ShortProduct or service provided
            Control0..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            The items to be processed for adjudication.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            156. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.modifierExtension
            Definition

            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).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            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.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            158. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.sequence
            Definition

            A number to uniquely identify item entries.

            ShortItem instance identifier
            Control1..1
            TypepositiveInt
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Requirements

            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            160. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity
            Definition

            The number of repetitions of a service or product.

            ShortPunkteanzahlCount of products or services
            Control10..1
            TypeQuantity(SimpleQuantity)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            Required when the product or service code does not convey the quantity provided.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            162. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.value
            Definition

            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

            ShortNumerical value (with implicit precision)
            Comments

            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).

            Control10..1
            Typedecimal
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Precision is handled implicitly in almost all cases of measurement.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            164. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.comparator
            Definition

            Not allowed to be used in this context


            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.

            Short< | <= | >= | > | ad - how to understand the value
            Control0..01
            BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0
            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

            How the Quantity should be understood and represented.

            Typecode
            Is Modifiertrue because 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
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

            Meaning if MissingIf there is no comparator, then there is no modification of the value
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            166. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.unit
            Definition

            A human-readable form of the unit.

            ShortUnit representation
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

            Pattern ValueLKF Punkte
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            168. Claim.item:ZusatzpunkteIntensiv
            Slice NameZusatzpunkteIntensiv
            Definition

            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.

            ShortProduct or service provided
            Control0..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            The items to be processed for adjudication.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            170. Claim.item:ZusatzpunkteIntensiv.modifierExtension
            Definition

            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).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            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.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            172. Claim.item:ZusatzpunkteIntensiv.sequence
            Definition

            A number to uniquely identify item entries.

            ShortItem instance identifier
            Control1..1
            TypepositiveInt
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Requirements

            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            174. Claim.item:ZusatzpunkteIntensiv.quantity
            Definition

            The number of repetitions of a service or product.

            ShortPunkteanzahlCount of products or services
            Control10..1
            TypeQuantity(SimpleQuantity)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            Required when the product or service code does not convey the quantity provided.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            176. Claim.item:ZusatzpunkteIntensiv.quantity.value
            Definition

            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

            ShortNumerical value (with implicit precision)
            Comments

            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).

            Control10..1
            Typedecimal
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Precision is handled implicitly in almost all cases of measurement.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            178. Claim.item:ZusatzpunkteIntensiv.quantity.comparator
            Definition

            Not allowed to be used in this context


            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.

            Short< | <= | >= | > | ad - how to understand the value
            Control0..01
            BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0
            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

            How the Quantity should be understood and represented.

            Typecode
            Is Modifiertrue because 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
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

            Meaning if MissingIf there is no comparator, then there is no modification of the value
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            180. Claim.item:ZusatzpunkteIntensiv.quantity.unit
            Definition

            A human-readable form of the unit.

            ShortUnit representation
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

            Pattern ValueLKF Punkte
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            182. Claim.item:ZusatzpunkteMehrfachleistungen
            Slice NameZusatzpunkteMehrfachleistungen
            Definition

            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.

            ShortProduct or service provided
            Control0..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            The items to be processed for adjudication.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            184. Claim.item:ZusatzpunkteMehrfachleistungen.modifierExtension
            Definition

            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).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            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.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            186. Claim.item:ZusatzpunkteMehrfachleistungen.sequence
            Definition

            A number to uniquely identify item entries.

            ShortItem instance identifier
            Control1..1
            TypepositiveInt
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Requirements

            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            188. Claim.item:ZusatzpunkteMehrfachleistungen.quantity
            Definition

            The number of repetitions of a service or product.

            ShortPunkteanzahlCount of products or services
            Control10..1
            TypeQuantity(SimpleQuantity)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            Required when the product or service code does not convey the quantity provided.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            190. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.value
            Definition

            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

            ShortNumerical value (with implicit precision)
            Comments

            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).

            Control10..1
            Typedecimal
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Precision is handled implicitly in almost all cases of measurement.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            192. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.comparator
            Definition

            Not allowed to be used in this context


            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.

            Short< | <= | >= | > | ad - how to understand the value
            Control0..01
            BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0
            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

            How the Quantity should be understood and represented.

            Typecode
            Is Modifiertrue because 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
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

            Meaning if MissingIf there is no comparator, then there is no modification of the value
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            194. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.unit
            Definition

            A human-readable form of the unit.

            ShortUnit representation
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

            Pattern ValueLKF Punkte
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            196. Claim.item:PunkteSpeziellerBereicheTageweise
            Slice NamePunkteSpeziellerBereicheTageweise
            Definition

            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.

            ShortProduct or service provided
            Control0..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            The items to be processed for adjudication.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            198. Claim.item:PunkteSpeziellerBereicheTageweise.modifierExtension
            Definition

            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).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            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.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            200. Claim.item:PunkteSpeziellerBereicheTageweise.sequence
            Definition

            A number to uniquely identify item entries.

            ShortItem instance identifier
            Control1..1
            TypepositiveInt
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Requirements

            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            202. Claim.item:PunkteSpeziellerBereicheTageweise.quantity
            Definition

            The number of repetitions of a service or product.

            ShortPunkteanzahlCount of products or services
            Control10..1
            TypeQuantity(SimpleQuantity)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            Required when the product or service code does not convey the quantity provided.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            204. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.value
            Definition

            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

            ShortNumerical value (with implicit precision)
            Comments

            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).

            Control10..1
            Typedecimal
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Precision is handled implicitly in almost all cases of measurement.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            206. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.comparator
            Definition

            Not allowed to be used in this context


            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.

            Short< | <= | >= | > | ad - how to understand the value
            Control0..01
            BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0
            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

            How the Quantity should be understood and represented.

            Typecode
            Is Modifiertrue because 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
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

            Meaning if MissingIf there is no comparator, then there is no modification of the value
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            208. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.unit
            Definition

            A human-readable form of the unit.

            ShortUnit representation
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

            Pattern ValueLKF Punkte
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            210. Claim.item:Gesamtpunkte
            Slice NameGesamtpunkte
            Definition

            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.

            ShortProduct or service provided
            Control10..1*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            The items to be processed for adjudication.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            212. Claim.item:Gesamtpunkte.modifierExtension
            Definition

            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).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            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.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            214. Claim.item:Gesamtpunkte.sequence
            Definition

            A number to uniquely identify item entries.

            ShortItem instance identifier
            Control1..1
            TypepositiveInt
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Requirements

            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            216. Claim.item:Gesamtpunkte.quantity
            Definition

            The number of repetitions of a service or product.

            ShortPunkteanzahlCount of products or services
            Control10..1
            TypeQuantity(SimpleQuantity)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Requirements

            Required when the product or service code does not convey the quantity provided.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            218. Claim.item:Gesamtpunkte.quantity.value
            Definition

            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

            ShortNumerical value (with implicit precision)
            Comments

            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).

            Control10..1
            Typedecimal
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Precision is handled implicitly in almost all cases of measurement.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            220. Claim.item:Gesamtpunkte.quantity.comparator
            Definition

            Not allowed to be used in this context


            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.

            Short< | <= | >= | > | ad - how to understand the value
            Control0..01
            BindingThe codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0
            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

            How the Quantity should be understood and represented.

            Typecode
            Is Modifiertrue because 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
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

            Meaning if MissingIf there is no comparator, then there is no modification of the value
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            222. Claim.item:Gesamtpunkte.quantity.unit
            Definition

            A human-readable form of the unit.

            ShortUnit representation
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

            Pattern ValueLKF Punkte
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

            Guidance on how to interpret the contents of this table can be foundhere

            0. Claim
            2. Claim.extension
            Control1..?
            SlicingThis element introduces a set of slices on Claim.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 4. Claim.extension:DiagnoseKnoten
              Slice NameDiagnoseKnoten
              Control1..1
              TypeExtension(Abrechnung - Knoten) (Extension Type: Coding)
              6. Claim.extension:FehlerWarnung
              Slice NameFehlerWarnung
              Control0..*
              TypeExtension(Error/Warning) (Complex Extension)
              8. Claim.type
              Pattern Value{
                "coding" : [{
                  "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
                  "code" : "institutional"
                }]
              }
              10. Claim.use
              Pattern Valueclaim
              12. Claim.patient
              TypeReference(HL7® AT Core Patient Profile)
              14. Claim.insurer
              Control1..?
              TypeReference(SV Organization)
              16. Claim.provider
              Control1..?
              TypeReference(KH Organization)
              18. Claim.related
              20. Claim.related.claim
              Control1..?
              TypeReference(MOPED LKFRequest)
              22. Claim.encounter
              Control2..?
              SlicingThis element introduces a set of slices on Claim.encounter. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • profile @ resolve()
              • 24. Claim.encounter:MopedEncounter
                Slice NameMopedEncounter
                ShortGenerelle Informationen zu Aufnahme und Entlassung des Patienten
                Control1..1
                TypeReference(MOPED Encounter)
                26. Claim.encounter:TransferEncounter
                Slice NameTransferEncounter
                ShortInformationen zu Verlegungen innerhalb oder zwischen Krankenanstalten
                Control1..*
                TypeReference(MOPED TransferEncounter)
                28. Claim.diagnosisRelatedGroup
                Short"Abrechnung - Gruppe:" Dieses Datenfeld ist mit der Codenummer der zutreffenden Abrechnungsgruppe zu befüllen. Bei Datensätzen von stationären Krankenhausaufenthalten, die keiner leistungsorientier- ten Diagnosenfallgruppe zugeordnet werden, erfolgt ein Eintrag entsprechend der jeweiligen Aufnahmeart.
                Control1..?
                BindingThe codes SHALL be taken from LKF Abrechnungsgruppe
                (required to https://elga.moped.at/ValueSet/LKFAbrechnungsGruppeVS)
                30. Claim.supportingInfo
                Control1..?
                SlicingThis element introduces a set of slices on Claim.supportingInfo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ category
                • 32. Claim.supportingInfo:Plausibilitaetskennzeichen
                  Slice NamePlausibilitaetskennzeichen
                  ShortPlausibilitätskennzeichen - Dieses Datenfeld enthält eine Kennzeichnung als Ergebnis der vom Gesundheitsministerium vorgegebenen Plausibilitätsprüfung.
                  Control1..1
                  34. Claim.supportingInfo:Plausibilitaetskennzeichen.category
                  Pattern Value{
                    "coding" : [{
                      "system" : "https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS",
                      "code" : "PLAUS"
                    }]
                  }
                  36. Claim.supportingInfo:Plausibilitaetskennzeichen.value[x]
                  Typestring
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  38. Claim.diagnosis
                  Control1..?
                  SlicingThis element introduces a set of slices on Claim.diagnosis. The slices areOrdered and Open, and can be differentiated using the following discriminators:
                  • value @ type.coding
                  • 40. Claim.diagnosis:Hauptdiagnose
                    Slice NameHauptdiagnose
                    Control1..*
                    42. Claim.diagnosis:Hauptdiagnose.diagnosis[x]
                    TypeReference(MOPED Condition)
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    44. Claim.diagnosis:Hauptdiagnose.type
                    BindingFor example codes, see ExampleDiagnosisTypeCodes
                    (example to http://hl7.org/fhir/ValueSet/ex-diagnosistype)

                    Code für den Typ der LKF Diagnose, der angibt ob es sich um eine Haupt- oder Nebendiagnose handelt

                    46. Claim.diagnosis:Hauptdiagnose.type.coding
                    Control1..?
                    BindingThe codes SHALL be taken from LKF Diagnosetyp ValueSet
                    (required to https://elga.moped.at/ValueSet/LKFDiagnoseTypVS)
                    Pattern Value{
                      "system" : "https://termgit.elga.gv.at/ValueSet/lkf-diagnose-typ",
                      "code" : "H"
                    }
                    48. Claim.diagnosis:Hauptdiagnose.onAdmission
                    Definition

                    Gibt an ob die Diagnose bereits bei Aufnahme in den stationären Aufenthalt vorhanden war

                    50. Claim.diagnosis:Zusatzdiagnose
                    Slice NameZusatzdiagnose
                    Control0..*
                    52. Claim.diagnosis:Zusatzdiagnose.diagnosis[x]
                    TypeReference(MOPED Condition)
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    54. Claim.diagnosis:Zusatzdiagnose.type
                    BindingFor example codes, see ExampleDiagnosisTypeCodes
                    (example to http://hl7.org/fhir/ValueSet/ex-diagnosistype)

                    Code für den Typ der LKF Diagnose, der angibt ob es sich um eine Haupt- oder Nebendiagnose handelt

                    56. Claim.diagnosis:Zusatzdiagnose.type.coding
                    Control1..?
                    BindingThe codes SHALL be taken from LKF Diagnosetyp ValueSet
                    (required to https://elga.moped.at/ValueSet/LKFDiagnoseTypVS)
                    Pattern Value{
                      "system" : "https://termgit.elga.gv.at/ValueSet/lkf-diagnose-typ",
                      "code" : "Z"
                    }
                    58. Claim.diagnosis:Zusatzdiagnose.onAdmission
                    Definition

                    Gibt an ob die Diagnose bereits bei Aufnahme in den stationären Aufenthalt vorhanden war

                    60. Claim.procedure
                    62. Claim.procedure.extension
                    Control1..?
                    SlicingThis element introduces a set of slices on Claim.procedure.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 64. Claim.procedure.extension:AbrechnungsRelevanz
                      Slice NameAbrechnungsRelevanz
                      Control1..1
                      TypeExtension(Medizinische Leistung - Abrechnungsrelevanz) (Extension Type: Coding)
                      66. Claim.insurance
                      68. Claim.insurance.coverage
                      TypeReference(MOPED Coverage)
                      70. Claim.item
                      Control3..?
                      SlicingThis element introduces a set of slices on Claim.item. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ category.coding
                      • 72. Claim.item:Leistungskomponente
                        Slice NameLeistungskomponente
                        Control1..1
                        74. Claim.item:Leistungskomponente.category
                        BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                        (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                        76. Claim.item:Leistungskomponente.category.coding
                        Control1..?
                        Pattern Value{
                          "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                          "code" : "LDFPLK"
                        }
                        78. Claim.item:Leistungskomponente.quantity
                        ShortPunkteanzahl
                        Control1..?
                        80. Claim.item:Leistungskomponente.quantity.unit
                        Pattern ValueLKF Punkte
                        82. Claim.item:Tageskomponente
                        Slice NameTageskomponente
                        Control1..1
                        84. Claim.item:Tageskomponente.category
                        86. Claim.item:Tageskomponente.category.coding
                        Control1..?
                        BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                        (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                        Pattern Value{
                          "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                          "code" : "LDFPTK"
                        }
                        88. Claim.item:Tageskomponente.quantity
                        ShortPunkteanzahl
                        Control1..?
                        90. Claim.item:Tageskomponente.quantity.value
                        Control1..?
                        92. Claim.item:Tageskomponente.quantity.unit
                        Pattern ValueLKF Punkte
                        94. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente
                        Slice NamePunkteBelagsdauerausreisserUntenLeistungskomponente
                        Control0..1
                        96. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.category
                        98. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.category.coding
                        Control1..?
                        BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                        (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                        Pattern Value{
                          "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                          "code" : "SCULK"
                        }
                        100. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity
                        ShortPunkteanzahl
                        Control1..?
                        102. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.value
                        Control1..?
                        104. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.unit
                        Pattern ValueLKF Punkte
                        106. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente
                        Slice NamePunkteBelagsdauerausreisserUntenTageskomponente
                        Control0..1
                        108. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.category
                        110. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.category.coding
                        Control1..?
                        BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                        (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                        Pattern Value{
                          "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                          "code" : "SCUTK"
                        }
                        112. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity
                        ShortPunkteanzahl
                        Control1..?
                        114. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.value
                        Control1..?
                        116. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.unit
                        Pattern ValueLKF Punkte
                        118. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben
                        Slice NameZusatzpunkteBelagsdauerausreisserNachOben
                        Control0..1
                        120. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.category
                        122. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.category.coding
                        Control1..?
                        BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                        (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                        Pattern Value{
                          "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                          "code" : "BDZU"
                        }
                        124. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity
                        ShortPunkteanzahl
                        Control1..?
                        126. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.value
                        Control1..?
                        128. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.unit
                        Pattern ValueLKF Punkte
                        130. Claim.item:ZusatzpunkteIntensiv
                        Slice NameZusatzpunkteIntensiv
                        Control0..1
                        132. Claim.item:ZusatzpunkteIntensiv.category
                        134. Claim.item:ZusatzpunkteIntensiv.category.coding
                        Control1..?
                        BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                        (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                        Pattern Value{
                          "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                          "code" : "INTZU"
                        }
                        136. Claim.item:ZusatzpunkteIntensiv.quantity
                        ShortPunkteanzahl
                        Control1..?
                        138. Claim.item:ZusatzpunkteIntensiv.quantity.value
                        Control1..?
                        140. Claim.item:ZusatzpunkteIntensiv.quantity.unit
                        Pattern ValueLKF Punkte
                        142. Claim.item:ZusatzpunkteMehrfachleistungen
                        Slice NameZusatzpunkteMehrfachleistungen
                        Control0..1
                        144. Claim.item:ZusatzpunkteMehrfachleistungen.category
                        146. Claim.item:ZusatzpunkteMehrfachleistungen.category.coding
                        Control1..?
                        BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                        (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                        Pattern Value{
                          "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                          "code" : "MELZU"
                        }
                        148. Claim.item:ZusatzpunkteMehrfachleistungen.quantity
                        ShortPunkteanzahl
                        Control1..?
                        150. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.value
                        Control1..?
                        152. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.unit
                        Pattern ValueLKF Punkte
                        154. Claim.item:PunkteSpeziellerBereicheTageweise
                        Slice NamePunkteSpeziellerBereicheTageweise
                        Control0..1
                        156. Claim.item:PunkteSpeziellerBereicheTageweise.category
                        158. Claim.item:PunkteSpeziellerBereicheTageweise.category.coding
                        Control1..?
                        BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                        (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                        Pattern Value{
                          "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                          "code" : "SCSPEZ"
                        }
                        160. Claim.item:PunkteSpeziellerBereicheTageweise.quantity
                        ShortPunkteanzahl
                        Control1..?
                        162. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.value
                        Control1..?
                        164. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.unit
                        Pattern ValueLKF Punkte
                        166. Claim.item:Gesamtpunkte
                        Slice NameGesamtpunkte
                        Control1..1
                        168. Claim.item:Gesamtpunkte.category
                        170. Claim.item:Gesamtpunkte.category.coding
                        Control1..?
                        BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                        (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                        Pattern Value{
                          "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                          "code" : "SCGES"
                        }
                        172. Claim.item:Gesamtpunkte.quantity
                        ShortPunkteanzahl
                        Control1..?
                        174. Claim.item:Gesamtpunkte.quantity.value
                        Control1..?
                        176. Claim.item:Gesamtpunkte.quantity.unit
                        Pattern ValueLKF Punkte

                        Guidance on how to interpret the contents of this table can be foundhere

                        0. Claim
                        Definition

                        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.

                        ShortClaim, Pre-determination or Pre-authorization
                        Comments

                        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.

                        Control0..*
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Alternate NamesAdjudication Request, Preauthorization Request, Predetermination Request
                        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                        dom-3: 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 (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())
                        dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                        dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                        dom-6: A resource should have narrative for robust management (text.`div`.exists())
                        2. Claim.id
                        Definition

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

                        ShortLogical id of this artifact
                        Comments

                        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.

                        Control0..1
                        Typeid
                        Is Modifierfalse
                        Must Supportfalse
                        Summarytrue
                        4. Claim.meta
                        Definition

                        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.

                        ShortMetadata about the resource
                        Control0..1
                        TypeMeta
                        Is Modifierfalse
                        Must Supportfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        6. Claim.implicitRules
                        Definition

                        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.

                        ShortA set of rules under which this content was created
                        Comments

                        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.

                        Control0..1
                        Typeuri
                        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supportfalse
                        Summarytrue
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        8. Claim.language
                        Definition

                        The base language in which the resource is written.

                        ShortLanguage of the resource content
                        Comments

                        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).

                        Control0..1
                        BindingThe codes SHALL be taken from AllLanguages
                        (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

                        IETF language tag for a human language

                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        10. Claim.text
                        Definition

                        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.

                        ShortText summary of the resource, for human interpretation
                        Comments

                        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.

                        Control0..1
                        This element is affected by the following invariants: dom-6
                        TypeNarrative
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Alternate Namesnarrative, html, xhtml, display
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        12. Claim.contained
                        Definition

                        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.

                        ShortContained, inline Resources
                        Comments

                        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.

                        Control0..*
                        This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
                        TypeResource
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Alternate Namesinline resources, anonymous resources, contained resources
                        14. Claim.extension
                        Definition

                        An Extension

                        ShortExtension
                        Control1..*
                        TypeExtension
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingThis element introduces a set of slices on Claim.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 16. Claim.extension:DiagnoseKnoten
                          Slice NameDiagnoseKnoten
                          Definition

                          "Abrechnung - Knoten:" Lukriert die Patient:innen über eine reguläre Gruppe Punkte, so ist in diesem Datenfeld die entsprechende Knotenbezeichnung einzutragen.

                          Short"Abrechnung - Knoten:" Lukriert die Patient:innen über eine reguläre Gruppe Punkte, so ist in diesem Datenfeld die entsprechende Knotenbezeichnung einzutragen.
                          Control1..1
                          TypeExtension(Abrechnung - Knoten) (Extension Type: Coding)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          18. Claim.extension:FehlerWarnung
                          Slice NameFehlerWarnung
                          Definition

                          MOPED Extension für akzeptierte Errors und Warnings

                          ShortError/Warning
                          Control0..*
                          TypeExtension(Error/Warning) (Complex Extension)
                          Is Modifierfalse
                          Must Supportfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          20. Claim.modifierExtension
                          Definition

                          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).

                          ShortExtensions that cannot be ignored
                          Comments

                          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.

                          Control0..*
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                          Must Supportfalse
                          Summarytrue
                          Requirements

                          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.

                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          22. Claim.identifier
                          Definition

                          A unique identifier assigned to this claim.

                          ShortBusiness Identifier for claim
                          NoteThis is a business identifier, not a resource identifier (see discussion)
                          Control0..*
                          TypeIdentifier
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          Allows claims to be distinguished and referenced.

                          Alternate NamesClaim Number
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          24. Claim.traceNumber
                          Definition

                          Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                          ShortNumber for tracking
                          Control0..*
                          TypeIdentifier
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          Allows partners to uniquely identify components for tracking.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          26. Claim.status
                          Definition

                          The status of the resource instance.

                          Shortactive | cancelled | draft | entered-in-error
                          Comments

                          This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                          Control1..1
                          BindingThe codes SHALL be taken from FinancialResourceStatusCodes
                          (required to http://hl7.org/fhir/ValueSet/fm-status|5.0.0)

                          A code specifying the state of the resource instance.

                          Typecode
                          Is Modifiertrue because 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
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summarytrue
                          Requirements

                          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'.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          28. Claim.type
                          Definition

                          The category of claim, e.g. oral, pharmacy, vision, institutional, professional.

                          ShortCategory or discipline
                          Comments

                          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.

                          Control1..1
                          BindingUnless not suitable, these codes SHALL be taken from ClaimTypeCodes
                          (extensible to http://hl7.org/fhir/ValueSet/claim-type)

                          The type or discipline-style of the claim.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Requirements

                          Claim type determine the general sets of business rules applied for information requirements and adjudication.

                          Pattern Value{
                            "coding" : [{
                              "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
                              "code" : "institutional"
                            }]
                          }
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          30. Claim.subType
                          Definition

                          A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.

                          ShortMore granular claim type
                          Comments

                          This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type.

                          Control0..1
                          BindingFor example codes, see ExampleClaimSubTypeCodes
                          (example to http://hl7.org/fhir/ValueSet/claim-subtype)

                          A more granular claim typecode.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          Some jurisdictions need a finer grained claim type for routing and adjudication.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          32. Claim.use
                          Definition

                          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.

                          Shortclaim | preauthorization | predetermination
                          Control1..1
                          BindingThe codes SHALL be taken from Use
                          (required to http://hl7.org/fhir/ValueSet/claim-use|5.0.0)

                          The purpose of the Claim: predetermination, preauthorization, claim.

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summarytrue
                          Requirements

                          This element is required to understand the nature of the request for adjudication.

                          Pattern Valueclaim
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          34. Claim.patient
                          Definition

                          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.

                          ShortThe recipient of the products and services
                          Control1..1
                          TypeReference(HL7® AT Core Patient Profile)
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Requirements

                          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.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          36. Claim.billablePeriod
                          Definition

                          The period for which charges are being submitted.

                          ShortRelevant time frame for the claim
                          Comments

                          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.

                          Control0..1
                          TypePeriod
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Requirements

                          A number jurisdictions required the submission of the billing period when submitting claims for example for hospital stays or long-term care.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          38. Claim.created
                          Definition

                          The date this resource was created.

                          ShortResource creation date
                          Comments

                          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.

                          Control1..1
                          TypedateTime
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summarytrue
                          Requirements

                          Need to record a timestamp for use by both the recipient and the issuer.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          40. Claim.enterer
                          Definition

                          Individual who created the claim, predetermination or preauthorization.

                          ShortAuthor of the claim
                          Control0..1
                          TypeReference(Practitioner, PractitionerRole, Patient, RelatedPerson)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          Some jurisdictions require the contact information for personnel completing claims.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          42. Claim.insurer
                          Definition

                          The Insurer who is target of the request.

                          ShortTarget
                          Control1..1
                          TypeReference(SV Organization)
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          44. Claim.provider
                          Definition

                          The provider which is responsible for the claim, predetermination or preauthorization.

                          ShortParty responsible for the claim
                          Comments

                          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.

                          Control1..1
                          TypeReference(KH Organization)
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          46. Claim.priority
                          Definition

                          The provider-required urgency of processing the request. Typical values include: stat, normal, deferred.

                          ShortDesired processing urgency
                          Comments

                          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.

                          Control0..1
                          BindingFor example codes, see ProcessPriorityCodes
                          (example to http://hl7.org/fhir/ValueSet/process-priority)

                          The timeliness with which processing is required: stat, normal, deferred.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summarytrue
                          Requirements

                          The provider may need to indicate their processing requirements so that the processor can indicate if they are unable to comply.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          48. Claim.fundsReserve
                          Definition

                          A code to indicate whether and for whom funds are to be reserved for future claims.

                          ShortFor whom to reserve funds
                          Comments

                          This field is only used for preauthorizations.

                          Control0..1
                          BindingFor example codes, see FundsReservationCodes
                          (example to http://hl7.org/fhir/ValueSet/fundsreserve)

                          For whom funds are to be reserved: (Patient, Provider, None).

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          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.

                          Alternate NamesFund pre-allocation
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          50. Claim.related
                          Definition

                          Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.

                          ShortPrior or corollary claims
                          Comments

                          For example, for the original treatment and follow-up exams.

                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          For workplace or other accidents it is common to relate separate claims arising from the same event.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          52. Claim.related.id
                          Definition

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

                          ShortUnique id for inter-element referencing
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          54. Claim.related.extension
                          Definition

                          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.

                          ShortAdditional content defined by implementations
                          Comments

                          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.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          56. Claim.related.modifierExtension
                          Definition

                          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).

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

                          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.

                          Control0..*
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                          Summarytrue
                          Requirements

                          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.

                          Alternate Namesextensions, user content, modifiers
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          58. Claim.related.claim
                          Definition

                          Reference to a related claim.

                          ShortReference to the related claim
                          Control1..1
                          TypeReference(MOPED LKFRequest)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          For workplace or other accidents it is common to relate separate claims arising from the same event.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          60. Claim.related.relationship
                          Definition

                          A code to convey how the claims are related.

                          ShortHow the reference claim is related
                          Comments

                          For example, prior claim or umbrella.

                          Control0..1
                          BindingFor example codes, see ExampleRelatedClaimRelationshipCodes
                          (example to http://hl7.org/fhir/ValueSet/related-claim-relationship)

                          Relationship of this claim to a related Claim.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          Some insurers need a declaration of the type of relationship.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          62. Claim.related.reference
                          Definition

                          An alternate organizational reference to the case or file to which this particular claim pertains.

                          ShortFile or case reference
                          Comments

                          For example, Property/Casualty insurer claim # or Workers Compensation case # .

                          Control0..1
                          TypeIdentifier
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          In cases where an event-triggered claim is being submitted to an insurer which requires a reference number to be specified on all exchanges.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          64. Claim.prescription
                          Definition

                          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.

                          ShortPrescription authorizing services and products
                          Control0..1
                          TypeReference(DeviceRequest, MedicationRequest, VisionPrescription)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          Required to authorize the dispensing of controlled substances and devices.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          66. Claim.originalPrescription
                          Definition

                          Original prescription which has been superseded by this prescription to support the dispensing of pharmacy services, medications or products.

                          ShortOriginal prescription if superseded by fulfiller
                          Comments

                          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'.

                          Control0..1
                          TypeReference(DeviceRequest, MedicationRequest, VisionPrescription)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          Often required when a fulfiller varies what is fulfilled from that authorized on the original prescription.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          68. Claim.payee
                          Definition

                          The party to be reimbursed for cost of the products and services according to the terms of the policy.

                          ShortRecipient of benefits payable
                          Comments

                          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.

                          Control0..1
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          The provider needs to specify who they wish to be reimbursed and the claims processor needs express who they will reimburse.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          70. Claim.payee.id
                          Definition

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

                          ShortUnique id for inter-element referencing
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          72. Claim.payee.extension
                          Definition

                          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.

                          ShortAdditional content defined by implementations
                          Comments

                          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.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          74. Claim.payee.modifierExtension
                          Definition

                          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).

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

                          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.

                          Control0..*
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                          Summarytrue
                          Requirements

                          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.

                          Alternate Namesextensions, user content, modifiers
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          76. Claim.payee.type
                          Definition

                          Type of Party to be reimbursed: subscriber, provider, other.

                          ShortCategory of recipient
                          Control1..1
                          BindingFor example codes, see ClaimPayeeTypeCodes
                          (example to http://hl7.org/fhir/ValueSet/payeetype)

                          A code for the party to be reimbursed.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          Need to know who should receive payment with the most common situations being the Provider (assignment of benefits) or the Subscriber.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          78. Claim.payee.party
                          Definition

                          Reference to the individual or organization to whom any payment will be made.

                          ShortRecipient reference
                          Comments

                          Not required if the payee is 'subscriber' or 'provider'.

                          Control0..1
                          TypeReference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          Need to provide demographics if the payee is not 'subscriber' nor 'provider'.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          80. Claim.referral
                          Definition

                          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.

                          ShortTreatment referral
                          Comments

                          The referral resource which lists the date, practitioner, reason and other supporting information.

                          Control0..1
                          TypeReference(ServiceRequest)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          Some insurers require proof of referral to pay for services or to pay specialist rates for services.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          82. Claim.encounter
                          Definition

                          Healthcare encounters related to this claim.

                          ShortEncounters associated with the listed treatments
                          Comments

                          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.

                          Control2..*
                          TypeReference(Encounter)
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          Used in some jurisdictions to link clinical events to claim items.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on Claim.encounter. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • profile @ resolve()
                          • 84. Claim.encounter:MopedEncounter
                            Slice NameMopedEncounter
                            Definition

                            Healthcare encounters related to this claim.

                            ShortGenerelle Informationen zu Aufnahme und Entlassung des Patienten
                            Comments

                            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.

                            Control1..1
                            TypeReference(MOPED Encounter)
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Requirements

                            Used in some jurisdictions to link clinical events to claim items.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            86. Claim.encounter:TransferEncounter
                            Slice NameTransferEncounter
                            Definition

                            Healthcare encounters related to this claim.

                            ShortInformationen zu Verlegungen innerhalb oder zwischen Krankenanstalten
                            Comments

                            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.

                            Control1..*
                            TypeReference(MOPED TransferEncounter)
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Requirements

                            Used in some jurisdictions to link clinical events to claim items.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            88. Claim.facility
                            Definition

                            Facility where the services were provided.

                            ShortServicing facility
                            Control0..1
                            TypeReference(Location, Organization)
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Requirements

                            Insurance adjudication can be dependant on where services were delivered.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            90. Claim.diagnosisRelatedGroup
                            Definition

                            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.

                            Short"Abrechnung - Gruppe:" Dieses Datenfeld ist mit der Codenummer der zutreffenden Abrechnungsgruppe zu befüllen. Bei Datensätzen von stationären Krankenhausaufenthalten, die keiner leistungsorientier- ten Diagnosenfallgruppe zugeordnet werden, erfolgt ein Eintrag entsprechend der jeweiligen Aufnahmeart.
                            Comments

                            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.

                            Control1..1
                            BindingThe codes SHALL be taken from LKF Abrechnungsgruppe
                            (required to https://elga.moped.at/ValueSet/LKFAbrechnungsGruppeVS)
                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Requirements

                            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.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            92. Claim.event
                            Definition

                            Information code for an event with a corresponding date or period.

                            ShortEvent information
                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            94. Claim.event.id
                            Definition

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

                            ShortUnique id for inter-element referencing
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            96. Claim.event.extension
                            Definition

                            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.

                            ShortAdditional content defined by implementations
                            Comments

                            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.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            98. Claim.event.modifierExtension
                            Definition

                            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).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            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.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            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.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            100. Claim.event.type
                            Definition

                            A coded event such as when a service is expected or a card printed.

                            ShortSpecific event
                            Control1..1
                            BindingFor example codes, see DatesTypeCodes
                            (example to http://hl7.org/fhir/ValueSet/datestype)
                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            102. Claim.event.when[x]
                            Definition

                            A date or period in the past or future indicating when the event occurred or is expectd to occur.

                            ShortOccurance date or period
                            Control1..1
                            TypeChoice of: dateTime, Period
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supportfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            104. Claim.careTeam
                            Definition

                            The members of the team who provided the products and services.

                            ShortMembers of the care team
                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Requirements

                            Common to identify the responsible and supporting practitioners.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            106. Claim.careTeam.id
                            Definition

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

                            ShortUnique id for inter-element referencing
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            108. Claim.careTeam.extension
                            Definition

                            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.

                            ShortAdditional content defined by implementations
                            Comments

                            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.

                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            110. Claim.careTeam.modifierExtension
                            Definition

                            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).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            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.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            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.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            112. Claim.careTeam.sequence
                            Definition

                            A number to uniquely identify care team entries.

                            ShortOrder of care team
                            Control1..1
                            TypepositiveInt
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supportfalse
                            Summaryfalse
                            Requirements

                            Necessary to maintain the order of the care team and provide a mechanism to link individuals to claim details.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            114. Claim.careTeam.provider
                            Definition

                            Member of the team who provided the product or service.

                            ShortPractitioner or organization
                            Control1..1
                            TypeReference(Practitioner, PractitionerRole, Organization)
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Requirements

                            Often a regulatory requirement to specify the responsible provider.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            116. Claim.careTeam.responsible
                            Definition

                            The party who is billing and/or responsible for the claimed products or services.

                            ShortIndicator of the lead practitioner
                            Comments

                            Responsible might not be required when there is only a single provider listed.

                            Control0..1
                            Typeboolean
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supportfalse
                            Summaryfalse
                            Requirements

                            When multiple parties are present it is required to distinguish the lead or responsible individual.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            118. Claim.careTeam.role
                            Definition

                            The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team.

                            ShortFunction within the team
                            Comments

                            Role might not be required when there is only a single provider listed.

                            Control0..1
                            BindingFor example codes, see ClaimCareTeamRoleCodes
                            (example to http://hl7.org/fhir/ValueSet/claim-careteamrole)

                            The role codes for the care team members.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Requirements

                            When multiple parties are present it is required to distinguish the roles performed by each member.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            120. Claim.careTeam.specialty
                            Definition

                            The specialization of the practitioner or provider which is applicable for this service.

                            ShortPractitioner or provider specialization
                            Control0..1
                            BindingFor example codes, see ExampleProviderQualificationCodes
                            (example to http://hl7.org/fhir/ValueSet/provider-qualification)
                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Requirements

                            Need to specify which specialization a practitioner or provider acting under when delivering the product or service.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            122. Claim.supportingInfo
                            Definition

                            Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.

                            ShortSupporting information
                            Comments

                            Often there are multiple jurisdiction specific valuesets which are required.

                            Control1..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Requirements

                            Typically these information codes are required to support the services rendered or the adjudication of the services rendered.

                            Alternate NamesAttachments Exception Codes Occurrence Codes Value codes
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            SlicingThis element introduces a set of slices on Claim.supportingInfo. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ category
                            • 124. Claim.supportingInfo.id
                              Definition

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

                              ShortUnique id for inter-element referencing
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              126. Claim.supportingInfo.extension
                              Definition

                              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.

                              ShortAdditional content defined by implementations
                              Comments

                              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.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              128. Claim.supportingInfo.modifierExtension
                              Definition

                              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).

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

                              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.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                              Summarytrue
                              Requirements

                              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.

                              Alternate Namesextensions, user content, modifiers
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              130. Claim.supportingInfo.sequence
                              Definition

                              A number to uniquely identify supporting information entries.

                              ShortInformation instance identifier
                              Control1..1
                              TypepositiveInt
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              132. Claim.supportingInfo.category
                              Definition

                              The general class of the information supplied: information; exception; accident, employment; onset, etc.

                              ShortClassification of the supplied information
                              Comments

                              This may contain a category for the local bill type codes.

                              Control1..1
                              BindingFor example codes, see ClaimInformationCategoryCodes
                              (example to http://hl7.org/fhir/ValueSet/claim-informationcategory)

                              The valuset used for additional information category codes.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Required to group or associate information items with common characteristics. For example: admission information or prior treatments.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              134. Claim.supportingInfo.code
                              Definition

                              System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.

                              ShortType of information
                              Control0..1
                              BindingFor example codes, see ExceptionCodes
                              (example to http://hl7.org/fhir/ValueSet/claim-exception)

                              The valuset used for additional information codes.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Required to identify the kind of additional information.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              136. Claim.supportingInfo.timing[x]
                              Definition

                              The date when or period to which this information refers.

                              ShortWhen it occurred
                              Control0..1
                              TypeChoice of: date, Period
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supportfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              138. Claim.supportingInfo.value[x]
                              Definition

                              Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.

                              ShortData to be provided
                              Comments

                              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.

                              Control0..1
                              TypeChoice of: boolean, string, Quantity, Attachment, Reference(Resource), Identifier
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              To convey the data content to be provided when the information is more than a simple code or period.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              140. Claim.supportingInfo.reason
                              Definition

                              Provides the reason in the situation where a reason code is required in addition to the content.

                              ShortExplanation for the information
                              Comments

                              For example: the reason for the additional stay, or why a tooth is missing.

                              Control0..1
                              BindingFor example codes, see MissingToothReasonCodes
                              (example to http://hl7.org/fhir/ValueSet/missing-tooth-reason)

                              Reason codes for the missing teeth.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Needed when the supporting information has both a date and amount/value and requires explanation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              142. Claim.supportingInfo:Plausibilitaetskennzeichen
                              Slice NamePlausibilitaetskennzeichen
                              Definition

                              Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.

                              ShortPlausibilitätskennzeichen - Dieses Datenfeld enthält eine Kennzeichnung als Ergebnis der vom Gesundheitsministerium vorgegebenen Plausibilitätsprüfung.
                              Comments

                              Often there are multiple jurisdiction specific valuesets which are required.

                              Control1..1
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Typically these information codes are required to support the services rendered or the adjudication of the services rendered.

                              Alternate NamesAttachments Exception Codes Occurrence Codes Value codes
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              144. Claim.supportingInfo:Plausibilitaetskennzeichen.id
                              Definition

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

                              ShortUnique id for inter-element referencing
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              Typestring
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              146. Claim.supportingInfo:Plausibilitaetskennzeichen.extension
                              Definition

                              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.

                              ShortAdditional content defined by implementations
                              Comments

                              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.

                              Control0..*
                              TypeExtension
                              Is Modifierfalse
                              Summaryfalse
                              Alternate Namesextensions, user content
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              148. Claim.supportingInfo:Plausibilitaetskennzeichen.modifierExtension
                              Definition

                              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).

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

                              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.

                              Control0..*
                              TypeExtension
                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                              Summarytrue
                              Requirements

                              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.

                              Alternate Namesextensions, user content, modifiers
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              150. Claim.supportingInfo:Plausibilitaetskennzeichen.sequence
                              Definition

                              A number to uniquely identify supporting information entries.

                              ShortInformation instance identifier
                              Control1..1
                              TypepositiveInt
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              152. Claim.supportingInfo:Plausibilitaetskennzeichen.category
                              Definition

                              The general class of the information supplied: information; exception; accident, employment; onset, etc.

                              ShortClassification of the supplied information
                              Comments

                              This may contain a category for the local bill type codes.

                              Control1..1
                              BindingFor example codes, see ClaimInformationCategoryCodes
                              (example to http://hl7.org/fhir/ValueSet/claim-informationcategory)

                              The valuset used for additional information category codes.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Required to group or associate information items with common characteristics. For example: admission information or prior treatments.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS",
                                  "code" : "PLAUS"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              154. Claim.supportingInfo:Plausibilitaetskennzeichen.code
                              Definition

                              System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.

                              ShortType of information
                              Control0..1
                              BindingFor example codes, see ExceptionCodes
                              (example to http://hl7.org/fhir/ValueSet/claim-exception)

                              The valuset used for additional information codes.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Required to identify the kind of additional information.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              156. Claim.supportingInfo:Plausibilitaetskennzeichen.timing[x]
                              Definition

                              The date when or period to which this information refers.

                              ShortWhen it occurred
                              Control0..1
                              TypeChoice of: date, Period
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supportfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              158. Claim.supportingInfo:Plausibilitaetskennzeichen.value[x]
                              Definition

                              Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.

                              ShortData to be provided
                              Comments

                              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.

                              Control0..1
                              Typestring
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              To convey the data content to be provided when the information is more than a simple code or period.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              160. Claim.supportingInfo:Plausibilitaetskennzeichen.reason
                              Definition

                              Provides the reason in the situation where a reason code is required in addition to the content.

                              ShortExplanation for the information
                              Comments

                              For example: the reason for the additional stay, or why a tooth is missing.

                              Control0..1
                              BindingFor example codes, see MissingToothReasonCodes
                              (example to http://hl7.org/fhir/ValueSet/missing-tooth-reason)

                              Reason codes for the missing teeth.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Needed when the supporting information has both a date and amount/value and requires explanation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              162. Claim.diagnosis
                              Definition

                              Information about diagnoses relevant to the claim items.

                              ShortPertinent diagnosis information
                              Control1..*
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Required for the adjudication by provided context for the services and product listed.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              SlicingThis element introduces a set of slices on Claim.diagnosis. The slices areOrdered and Open, and can be differentiated using the following discriminators:
                              • value @ type.coding
                              • 164. Claim.diagnosis.id
                                Definition

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                166. Claim.diagnosis.extension
                                Definition

                                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.

                                ShortAdditional content defined by implementations
                                Comments

                                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.

                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                168. Claim.diagnosis.modifierExtension
                                Definition

                                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).

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

                                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.

                                Control0..*
                                TypeExtension
                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                Summarytrue
                                Requirements

                                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.

                                Alternate Namesextensions, user content, modifiers
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                170. Claim.diagnosis.sequence
                                Definition

                                A number to uniquely identify diagnosis entries.

                                ShortDiagnosis instance identifier
                                Comments

                                Diagnosis are presented in list order to their expected importance: primary, secondary, etc.

                                Control1..1
                                TypepositiveInt
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                172. Claim.diagnosis.diagnosis[x]
                                Definition

                                The nature of illness or problem in a coded form or as a reference to an external defined Condition.

                                ShortNature of illness or problem
                                Control1..1
                                BindingFor example codes, see ICD10Codes
                                (example to http://hl7.org/fhir/ValueSet/icd-10)

                                Example ICD10 Diagnostic codes.

                                TypeChoice of: CodeableConcept, Reference(Condition)
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                Provides health context for the evaluation of the products and/or services.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                174. Claim.diagnosis.type
                                Definition

                                When the condition was observed or the relative ranking.

                                ShortTiming or nature of the diagnosis
                                Comments

                                For example: admitting, primary, secondary, discharge.

                                Control0..*
                                BindingFor example codes, see ExampleDiagnosisTypeCodes
                                (example to http://hl7.org/fhir/ValueSet/ex-diagnosistype)

                                The type of the diagnosis: admitting, principal, discharge.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                Often required to capture a particular diagnosis, for example: primary or discharge.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                176. Claim.diagnosis.onAdmission
                                Definition

                                Indication of whether the diagnosis was present on admission to a facility.

                                ShortPresent on admission
                                Control0..1
                                BindingFor example codes, see ExampleDiagnosisOnAdmissionCodes
                                (example to http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission)

                                Present on admission.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                Many systems need to understand for adjudication if the diagnosis was present a time of admission.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                178. Claim.diagnosis:Hauptdiagnose
                                Slice NameHauptdiagnose
                                Definition

                                Information about diagnoses relevant to the claim items.

                                ShortPertinent diagnosis information
                                Control1..*
                                TypeBackboneElement
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                Required for the adjudication by provided context for the services and product listed.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                180. Claim.diagnosis:Hauptdiagnose.id
                                Definition

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                182. Claim.diagnosis:Hauptdiagnose.extension
                                Definition

                                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.

                                ShortAdditional content defined by implementations
                                Comments

                                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.

                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                184. Claim.diagnosis:Hauptdiagnose.modifierExtension
                                Definition

                                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).

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

                                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.

                                Control0..*
                                TypeExtension
                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                Summarytrue
                                Requirements

                                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.

                                Alternate Namesextensions, user content, modifiers
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                186. Claim.diagnosis:Hauptdiagnose.sequence
                                Definition

                                A number to uniquely identify diagnosis entries.

                                ShortDiagnosis instance identifier
                                Comments

                                Diagnosis are presented in list order to their expected importance: primary, secondary, etc.

                                Control1..1
                                TypepositiveInt
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                188. Claim.diagnosis:Hauptdiagnose.diagnosis[x]
                                Definition

                                The nature of illness or problem in a coded form or as a reference to an external defined Condition.

                                ShortNature of illness or problem
                                Control1..1
                                TypeReference(MOPED Condition)
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                Provides health context for the evaluation of the products and/or services.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                190. Claim.diagnosis:Hauptdiagnose.type
                                Definition

                                When the condition was observed or the relative ranking.

                                ShortTiming or nature of the diagnosis
                                Comments

                                For example: admitting, primary, secondary, discharge.

                                Control0..*
                                BindingFor example codes, see ExampleDiagnosisTypeCodes
                                (example to http://hl7.org/fhir/ValueSet/ex-diagnosistype)

                                Code für den Typ der LKF Diagnose, der angibt ob es sich um eine Haupt- oder Nebendiagnose handelt

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                Often required to capture a particular diagnosis, for example: primary or discharge.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                192. Claim.diagnosis:Hauptdiagnose.type.id
                                Definition

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typeid
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                194. Claim.diagnosis:Hauptdiagnose.type.extension
                                Definition

                                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.

                                ShortAdditional content defined by implementations
                                Comments

                                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.

                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Claim.diagnosis.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 196. Claim.diagnosis:Hauptdiagnose.type.coding
                                  Definition

                                  A reference to a code defined by a terminology system.

                                  ShortCode defined by a terminology system
                                  Comments

                                  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.

                                  Control1..*
                                  BindingThe codes SHALL be taken from LKF Diagnosetyp ValueSet
                                  (required to https://elga.moped.at/ValueSet/LKFDiagnoseTypVS)
                                  TypeCoding
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                  Pattern Value{
                                    "system" : "https://termgit.elga.gv.at/ValueSet/lkf-diagnose-typ",
                                    "code" : "H"
                                  }
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  198. Claim.diagnosis:Hauptdiagnose.type.text
                                  Definition

                                  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.

                                  ShortPlain text representation of the concept
                                  Comments

                                  Very often the text is the same as a displayName of one of the codings.

                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  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.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  200. Claim.diagnosis:Hauptdiagnose.onAdmission
                                  Definition

                                  Gibt an ob die Diagnose bereits bei Aufnahme in den stationären Aufenthalt vorhanden war

                                  ShortPresent on admission
                                  Control0..1
                                  BindingFor example codes, see ExampleDiagnosisOnAdmissionCodes
                                  (example to http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission)

                                  Present on admission.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Many systems need to understand for adjudication if the diagnosis was present a time of admission.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  202. Claim.diagnosis:Zusatzdiagnose
                                  Slice NameZusatzdiagnose
                                  Definition

                                  Information about diagnoses relevant to the claim items.

                                  ShortPertinent diagnosis information
                                  Control0..*
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Required for the adjudication by provided context for the services and product listed.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  204. Claim.diagnosis:Zusatzdiagnose.id
                                  Definition

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

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  206. Claim.diagnosis:Zusatzdiagnose.extension
                                  Definition

                                  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.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  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.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  208. Claim.diagnosis:Zusatzdiagnose.modifierExtension
                                  Definition

                                  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).

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

                                  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.

                                  Control0..*
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                  Summarytrue
                                  Requirements

                                  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.

                                  Alternate Namesextensions, user content, modifiers
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  210. Claim.diagnosis:Zusatzdiagnose.sequence
                                  Definition

                                  A number to uniquely identify diagnosis entries.

                                  ShortDiagnosis instance identifier
                                  Comments

                                  Diagnosis are presented in list order to their expected importance: primary, secondary, etc.

                                  Control1..1
                                  TypepositiveInt
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  212. Claim.diagnosis:Zusatzdiagnose.diagnosis[x]
                                  Definition

                                  The nature of illness or problem in a coded form or as a reference to an external defined Condition.

                                  ShortNature of illness or problem
                                  Control1..1
                                  TypeReference(MOPED Condition)
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Provides health context for the evaluation of the products and/or services.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  214. Claim.diagnosis:Zusatzdiagnose.type
                                  Definition

                                  When the condition was observed or the relative ranking.

                                  ShortTiming or nature of the diagnosis
                                  Comments

                                  For example: admitting, primary, secondary, discharge.

                                  Control0..*
                                  BindingFor example codes, see ExampleDiagnosisTypeCodes
                                  (example to http://hl7.org/fhir/ValueSet/ex-diagnosistype)

                                  Code für den Typ der LKF Diagnose, der angibt ob es sich um eine Haupt- oder Nebendiagnose handelt

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Often required to capture a particular diagnosis, for example: primary or discharge.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  216. Claim.diagnosis:Zusatzdiagnose.type.id
                                  Definition

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

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typeid
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  218. Claim.diagnosis:Zusatzdiagnose.type.extension
                                  Definition

                                  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.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  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.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on Claim.diagnosis.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 220. Claim.diagnosis:Zusatzdiagnose.type.coding
                                    Definition

                                    A reference to a code defined by a terminology system.

                                    ShortCode defined by a terminology system
                                    Comments

                                    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.

                                    Control1..*
                                    BindingThe codes SHALL be taken from LKF Diagnosetyp ValueSet
                                    (required to https://elga.moped.at/ValueSet/LKFDiagnoseTypVS)
                                    TypeCoding
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

                                    Allows for alternative encodings within a code system, and translations to other code systems.

                                    Pattern Value{
                                      "system" : "https://termgit.elga.gv.at/ValueSet/lkf-diagnose-typ",
                                      "code" : "Z"
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    222. Claim.diagnosis:Zusatzdiagnose.type.text
                                    Definition

                                    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.

                                    ShortPlain text representation of the concept
                                    Comments

                                    Very often the text is the same as a displayName of one of the codings.

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    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.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    224. Claim.diagnosis:Zusatzdiagnose.onAdmission
                                    Definition

                                    Gibt an ob die Diagnose bereits bei Aufnahme in den stationären Aufenthalt vorhanden war

                                    ShortPresent on admission
                                    Control0..1
                                    BindingFor example codes, see ExampleDiagnosisOnAdmissionCodes
                                    (example to http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission)

                                    Present on admission.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Requirements

                                    Many systems need to understand for adjudication if the diagnosis was present a time of admission.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    226. Claim.procedure
                                    Definition

                                    Procedures performed on the patient relevant to the billing items with the claim.

                                    ShortClinical procedures performed
                                    Control0..*
                                    TypeBackboneElement
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Requirements

                                    The specific clinical invention are sometimes required to be provided to justify billing a greater than customary amount for a service.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    228. Claim.procedure.id
                                    Definition

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

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    230. Claim.procedure.extension
                                    Definition

                                    An Extension

                                    ShortExtension
                                    Control1..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on Claim.procedure.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 232. Claim.procedure.extension:AbrechnungsRelevanz
                                      Slice NameAbrechnungsRelevanz
                                      Definition

                                      "Medizinische Leistung - Abrechnungsrelevanz:" Hier ist anzugeben, ob die medizinische Leistung bei der Bepunktung des ambulanten Besuchs/stationären Aufenthalts (Satzart X01) zu berücksichtigen ist.

                                      ShortMedizinische Leistung - Abrechnungsrelevanz
                                      Control1..1
                                      TypeExtension(Medizinische Leistung - Abrechnungsrelevanz) (Extension Type: Coding)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      234. Claim.procedure.modifierExtension
                                      Definition

                                      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).

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

                                      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.

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

                                      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.

                                      Alternate Namesextensions, user content, modifiers
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      236. Claim.procedure.sequence
                                      Definition

                                      A number to uniquely identify procedure entries.

                                      ShortProcedure instance identifier
                                      Control1..1
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Necessary to provide a mechanism to link to claim details.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      238. Claim.procedure.type
                                      Definition

                                      When the condition was observed or the relative ranking.

                                      ShortCategory of Procedure
                                      Comments

                                      For example: primary, secondary.

                                      Control0..*
                                      BindingFor example codes, see ExampleProcedureTypeCodes
                                      (example to http://hl7.org/fhir/ValueSet/ex-procedure-type)

                                      Example procedure type codes.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Often required to capture a particular diagnosis, for example: primary or discharge.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      240. Claim.procedure.date
                                      Definition

                                      Date and optionally time the procedure was performed.

                                      ShortWhen the procedure was performed
                                      Control0..1
                                      TypedateTime
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Required for auditing purposes.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      242. Claim.procedure.procedure[x]
                                      Definition

                                      The code or reference to a Procedure resource which identifies the clinical intervention performed.

                                      ShortSpecific clinical procedure
                                      Control1..1
                                      BindingFor example codes, see ICD10ProcedureCodes
                                      (example to http://hl7.org/fhir/ValueSet/icd-10-procedures)

                                      Example ICD10 Procedure codes.

                                      TypeChoice of: CodeableConcept, Reference(Procedure)
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      This identifies the actual clinical procedure.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      244. Claim.procedure.udi
                                      Definition

                                      Unique Device Identifiers associated with this line item.

                                      ShortUnique device identifier
                                      Control0..*
                                      TypeReference(Device)
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      The UDI code allows the insurer to obtain device level information on the product supplied.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      246. Claim.insurance
                                      Definition

                                      Financial instruments for reimbursement for the health care products and services specified on the claim.

                                      ShortPatient insurance information
                                      Comments

                                      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.

                                      Control0..*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summarytrue
                                      Requirements

                                      At least one insurer is required for a claim to be a claim.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      248. Claim.insurance.id
                                      Definition

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

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      250. Claim.insurance.extension
                                      Definition

                                      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.

                                      ShortAdditional content defined by implementations
                                      Comments

                                      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.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      252. Claim.insurance.modifierExtension
                                      Definition

                                      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).

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

                                      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.

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

                                      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.

                                      Alternate Namesextensions, user content, modifiers
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      254. Claim.insurance.sequence
                                      Definition

                                      A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order.

                                      ShortInsurance instance identifier
                                      Control1..1
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summarytrue
                                      Requirements

                                      To maintain order of the coverages.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      256. Claim.insurance.focal
                                      Definition

                                      A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true.

                                      ShortCoverage to be used for adjudication
                                      Comments

                                      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.

                                      Control1..1
                                      Typeboolean
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summarytrue
                                      Requirements

                                      To identify which coverage in the list is being used to adjudicate this claim.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      258. Claim.insurance.identifier
                                      Definition

                                      The business identifier to be used when the claim is sent for adjudication against this insurance policy.

                                      ShortPre-assigned Claim number
                                      Comments

                                      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'.

                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                      Control0..1
                                      TypeIdentifier
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      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.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      260. Claim.insurance.coverage
                                      Definition

                                      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.

                                      ShortInsurance information
                                      Control1..1
                                      TypeReference(MOPED Coverage)
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summarytrue
                                      Requirements

                                      Required to allow the adjudicator to locate the correct policy and history within their information system.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      262. Claim.insurance.businessArrangement
                                      Definition

                                      A business agreement number established between the provider and the insurer for special business processing purposes.

                                      ShortAdditional provider contract number
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Providers may have multiple business arrangements with a given insurer and must supply the specific contract number for adjudication.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      264. Claim.insurance.preAuthRef
                                      Definition

                                      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.

                                      ShortPrior authorization reference number
                                      Comments

                                      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.

                                      Control0..*
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Providers must quote previously issued authorization reference numbers in order to obtain adjudication as previously advised on the Preauthorization.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      266. Claim.insurance.claimResponse
                                      Definition

                                      The result of the adjudication of the line items for the Coverage specified in this insurance.

                                      ShortAdjudication results
                                      Comments

                                      Must not be specified when 'focal=true' for this insurance.

                                      Control0..1
                                      TypeReference(ClaimResponse)
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      An insurer need the adjudication results from prior insurers to determine the outstanding balance remaining by item for the items in the curent claim.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      268. Claim.accident
                                      Definition

                                      Details of an accident which resulted in injuries which required the products and services listed in the claim.

                                      ShortDetails of the event
                                      Control0..1
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      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.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      270. Claim.accident.id
                                      Definition

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

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      272. Claim.accident.extension
                                      Definition

                                      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.

                                      ShortAdditional content defined by implementations
                                      Comments

                                      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.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      274. Claim.accident.modifierExtension
                                      Definition

                                      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).

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

                                      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.

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

                                      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.

                                      Alternate Namesextensions, user content, modifiers
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      276. Claim.accident.date
                                      Definition

                                      Date of an accident event related to the products and services contained in the claim.

                                      ShortWhen the incident occurred
                                      Comments

                                      The date of the accident has to precede the dates of the products and services but within a reasonable timeframe.

                                      Control1..1
                                      Typedate
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Required for audit purposes and adjudication.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      278. Claim.accident.type
                                      Definition

                                      The type or context of the accident event for the purposes of selection of potential insurance coverages and determination of coordination between insurers.

                                      ShortThe nature of the accident
                                      Control0..1
                                      BindingUnless not suitable, these codes SHALL be taken from ActIncidentCode
                                      (extensible to http://terminology.hl7.org/ValueSet/v3-ActIncidentCode)

                                      Type of accident: work place, auto, etc.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Coverage may be dependant on the type of accident.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      280. Claim.accident.location[x]
                                      Definition

                                      The physical location of the accident event.

                                      ShortWhere the event occurred
                                      Control0..1
                                      TypeChoice of: Address, Reference(Location)
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Required for audit purposes and determination of applicable insurance liability.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      282. Claim.patientPaid
                                      Definition

                                      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.

                                      ShortPaid by the patient
                                      Control0..1
                                      TypeMoney
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      284. Claim.item
                                      Definition

                                      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.

                                      ShortProduct or service provided
                                      Control3..*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      The items to be processed for adjudication.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      SlicingThis element introduces a set of slices on Claim.item. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ category.coding
                                      • 286. Claim.item.id
                                        Definition

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

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        288. Claim.item.extension
                                        Definition

                                        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.

                                        ShortAdditional content defined by implementations
                                        Comments

                                        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.

                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        290. Claim.item.modifierExtension
                                        Definition

                                        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).

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

                                        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.

                                        Control0..*
                                        TypeExtension
                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                        Summarytrue
                                        Requirements

                                        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.

                                        Alternate Namesextensions, user content, modifiers
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        292. Claim.item.sequence
                                        Definition

                                        A number to uniquely identify item entries.

                                        ShortItem instance identifier
                                        Control1..1
                                        TypepositiveInt
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        294. Claim.item.traceNumber
                                        Definition

                                        Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                        ShortNumber for tracking
                                        Control0..*
                                        TypeIdentifier
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Allows partners to uniquely identify components for tracking.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        296. Claim.item.careTeamSequence
                                        Definition

                                        CareTeam members related to this service or product.

                                        ShortApplicable careTeam members
                                        Control0..*
                                        TypepositiveInt
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Need to identify the individuals and their roles in the provision of the product or service.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        298. Claim.item.diagnosisSequence
                                        Definition

                                        Diagnosis applicable for this service or product.

                                        ShortApplicable diagnoses
                                        Control0..*
                                        TypepositiveInt
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Need to related the product or service to the associated diagnoses.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        300. Claim.item.procedureSequence
                                        Definition

                                        Procedures applicable for this service or product.

                                        ShortApplicable procedures
                                        Control0..*
                                        TypepositiveInt
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Need to provide any listed specific procedures to support the product or service being claimed.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        302. Claim.item.informationSequence
                                        Definition

                                        Exceptions, special conditions and supporting information applicable for this service or product.

                                        ShortApplicable exception and supporting information
                                        Control0..*
                                        TypepositiveInt
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Need to reference the supporting information items that relate directly to this product or service.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        304. Claim.item.revenue
                                        Definition

                                        The type of revenue or cost center providing the product and/or service.

                                        ShortRevenue or cost center code
                                        Control0..1
                                        BindingFor example codes, see ExampleRevenueCenterCodes
                                        (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                        Codes for the revenue or cost centers supplying the service and/or products.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Needed in the processing of institutional claims.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        306. Claim.item.category
                                        Definition

                                        Code to identify the general type of benefits under which products and services are provided.

                                        ShortBenefit classification
                                        Comments

                                        Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                        Control0..1
                                        BindingFor example codes, see BenefitCategoryCodes
                                        (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                        Benefit categories such as: oral-basic, major, glasses.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        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.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        308. Claim.item.productOrService
                                        Definition

                                        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.

                                        ShortBilling, service, product, or drug code
                                        Comments

                                        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'.

                                        Control0..1
                                        BindingFor example codes, see USCLSCodes
                                        (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                        Allowable service and product codes.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Necessary to state what was provided or done.

                                        Alternate NamesDrug Code, Bill Code, Service Code
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        310. Claim.item.productOrServiceEnd
                                        Definition

                                        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.

                                        ShortEnd of a range of codes
                                        Control0..1
                                        BindingFor example codes, see USCLSCodes
                                        (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        312. Claim.item.request
                                        Definition

                                        Request or Referral for Goods or Service to be rendered.

                                        ShortRequest or Referral for Service
                                        Control0..*
                                        TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        May identify the service to be provided or provider authorization for the service.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        314. Claim.item.modifier
                                        Definition

                                        Item typification or modifiers codes to convey additional context for the product or service.

                                        ShortProduct or service billing modifiers
                                        Comments

                                        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.

                                        Control0..*
                                        BindingFor example codes, see ModifierTypeCodes
                                        (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                        Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        To support inclusion of the item for adjudication or to charge an elevated fee.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        316. Claim.item.programCode
                                        Definition

                                        Identifies the program under which this may be recovered.

                                        ShortProgram the product or service is provided under
                                        Comments

                                        For example: Neonatal program, child dental program or drug users recovery program.

                                        Control0..*
                                        BindingFor example codes, see ExampleProgramReasonCodes
                                        (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                        Program specific reason codes.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        318. Claim.item.serviced[x]
                                        Definition

                                        The date or dates when the service or product was supplied, performed or completed.

                                        ShortDate or dates of service or product delivery
                                        Control0..1
                                        TypeChoice of: date, Period
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        320. Claim.item.location[x]
                                        Definition

                                        Where the product or service was provided.

                                        ShortPlace of service or where product was supplied
                                        Control0..1
                                        BindingFor example codes, see ExampleServicePlaceCodes
                                        (example to http://hl7.org/fhir/ValueSet/service-place)

                                        Place of service: pharmacy, school, prison, etc.

                                        TypeChoice of: CodeableConcept, Address, Reference(Location)
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        322. Claim.item.patientPaid
                                        Definition

                                        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.

                                        ShortPaid by the patient
                                        Control0..1
                                        TypeMoney
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        324. Claim.item.quantity
                                        Definition

                                        The number of repetitions of a service or product.

                                        ShortCount of products or services
                                        Control0..1
                                        TypeQuantity(SimpleQuantity)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Required when the product or service code does not convey the quantity provided.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        326. Claim.item.unitPrice
                                        Definition

                                        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.

                                        ShortFee, charge or cost per item
                                        Control0..1
                                        TypeMoney
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        The amount charged to the patient by the provider for a single unit.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        328. Claim.item.factor
                                        Definition

                                        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.

                                        ShortPrice scaling factor
                                        Comments

                                        To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                        Control0..1
                                        Typedecimal
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        330. Claim.item.tax
                                        Definition

                                        The total of taxes applicable for this product or service.

                                        ShortTotal tax
                                        Control0..1
                                        TypeMoney
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Required when taxes are not embedded in the unit price or provided as a separate service.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        332. Claim.item.net
                                        Definition

                                        The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                        ShortTotal item cost
                                        Comments

                                        For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                        Control0..1
                                        TypeMoney
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Provides the total amount claimed for the group (if a grouper) or the line item.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        334. Claim.item.udi
                                        Definition

                                        Unique Device Identifiers associated with this line item.

                                        ShortUnique device identifier
                                        Control0..*
                                        TypeReference(Device)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        The UDI code allows the insurer to obtain device level information on the product supplied.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        336. Claim.item.bodySite
                                        Definition

                                        Physical location where the service is performed or applies.

                                        ShortAnatomical location
                                        Control0..*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        338. Claim.item.bodySite.id
                                        Definition

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

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        340. Claim.item.bodySite.extension
                                        Definition

                                        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.

                                        ShortAdditional content defined by implementations
                                        Comments

                                        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.

                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        342. Claim.item.bodySite.modifierExtension
                                        Definition

                                        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).

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

                                        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.

                                        Control0..*
                                        TypeExtension
                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                        Summarytrue
                                        Requirements

                                        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.

                                        Alternate Namesextensions, user content, modifiers
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        344. Claim.item.bodySite.site
                                        Definition

                                        Physical service site on the patient (limb, tooth, etc.).

                                        ShortLocation
                                        Comments

                                        For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                        Control1..*
                                        BindingFor example codes, see OralSiteCodes
                                        (example to http://hl7.org/fhir/ValueSet/tooth)
                                        TypeCodeableReference(BodyStructure)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Allows insurer to validate specific procedures.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        346. Claim.item.bodySite.subSite
                                        Definition

                                        A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                        ShortSub-location
                                        Control0..*
                                        BindingFor example codes, see SurfaceCodes
                                        (example to http://hl7.org/fhir/ValueSet/surface)
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Allows insurer to validate specific procedures.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        348. Claim.item.encounter
                                        Definition

                                        Healthcare encounters related to this claim.

                                        ShortEncounters associated with the listed treatments
                                        Comments

                                        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.

                                        Control0..*
                                        TypeReference(Encounter)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Used in some jurisdictions to link clinical events to claim items.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        350. Claim.item.detail
                                        Definition

                                        A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                        ShortProduct or service provided
                                        Control0..*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        The items to be processed for adjudication.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        352. Claim.item.detail.id
                                        Definition

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

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        354. Claim.item.detail.extension
                                        Definition

                                        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.

                                        ShortAdditional content defined by implementations
                                        Comments

                                        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.

                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        356. Claim.item.detail.modifierExtension
                                        Definition

                                        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).

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

                                        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.

                                        Control0..*
                                        TypeExtension
                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                        Summarytrue
                                        Requirements

                                        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.

                                        Alternate Namesextensions, user content, modifiers
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        358. Claim.item.detail.sequence
                                        Definition

                                        A number to uniquely identify item entries.

                                        ShortItem instance identifier
                                        Control1..1
                                        TypepositiveInt
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        360. Claim.item.detail.traceNumber
                                        Definition

                                        Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                        ShortNumber for tracking
                                        Control0..*
                                        TypeIdentifier
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Allows partners to uniquely identify components for tracking.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        362. Claim.item.detail.revenue
                                        Definition

                                        The type of revenue or cost center providing the product and/or service.

                                        ShortRevenue or cost center code
                                        Control0..1
                                        BindingFor example codes, see ExampleRevenueCenterCodes
                                        (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                        Codes for the revenue or cost centers supplying the service and/or products.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Needed in the processing of institutional claims.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        364. Claim.item.detail.category
                                        Definition

                                        Code to identify the general type of benefits under which products and services are provided.

                                        ShortBenefit classification
                                        Comments

                                        Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                        Control0..1
                                        BindingFor example codes, see BenefitCategoryCodes
                                        (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                        Benefit categories such as: oral-basic, major, glasses.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        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.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        366. Claim.item.detail.productOrService
                                        Definition

                                        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.

                                        ShortBilling, service, product, or drug code
                                        Comments

                                        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'.

                                        Control0..1
                                        BindingFor example codes, see USCLSCodes
                                        (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                        Allowable service and product codes.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Necessary to state what was provided or done.

                                        Alternate NamesDrug Code, Bill Code, Service Code
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        368. Claim.item.detail.productOrServiceEnd
                                        Definition

                                        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.

                                        ShortEnd of a range of codes
                                        Control0..1
                                        BindingFor example codes, see USCLSCodes
                                        (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        370. Claim.item.detail.modifier
                                        Definition

                                        Item typification or modifiers codes to convey additional context for the product or service.

                                        ShortService/Product billing modifiers
                                        Comments

                                        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.

                                        Control0..*
                                        BindingFor example codes, see ModifierTypeCodes
                                        (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                        Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        To support inclusion of the item for adjudication or to charge an elevated fee.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        372. Claim.item.detail.programCode
                                        Definition

                                        Identifies the program under which this may be recovered.

                                        ShortProgram the product or service is provided under
                                        Comments

                                        For example: Neonatal program, child dental program or drug users recovery program.

                                        Control0..*
                                        BindingFor example codes, see ExampleProgramReasonCodes
                                        (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                        Program specific reason codes.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        374. Claim.item.detail.patientPaid
                                        Definition

                                        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.

                                        ShortPaid by the patient
                                        Control0..1
                                        TypeMoney
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        376. Claim.item.detail.quantity
                                        Definition

                                        The number of repetitions of a service or product.

                                        ShortCount of products or services
                                        Control0..1
                                        TypeQuantity(SimpleQuantity)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Required when the product or service code does not convey the quantity provided.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        378. Claim.item.detail.unitPrice
                                        Definition

                                        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.

                                        ShortFee, charge or cost per item
                                        Control0..1
                                        TypeMoney
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        The amount charged to the patient by the provider for a single unit.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        380. Claim.item.detail.factor
                                        Definition

                                        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.

                                        ShortPrice scaling factor
                                        Comments

                                        To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                        Control0..1
                                        Typedecimal
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        382. Claim.item.detail.tax
                                        Definition

                                        The total of taxes applicable for this product or service.

                                        ShortTotal tax
                                        Control0..1
                                        TypeMoney
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Required when taxes are not embedded in the unit price or provided as a separate service.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        384. Claim.item.detail.net
                                        Definition

                                        The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                        ShortTotal item cost
                                        Comments

                                        For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                        Control0..1
                                        TypeMoney
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Provides the total amount claimed for the group (if a grouper) or the line item.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        386. Claim.item.detail.udi
                                        Definition

                                        Unique Device Identifiers associated with this line item.

                                        ShortUnique device identifier
                                        Control0..*
                                        TypeReference(Device)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        The UDI code allows the insurer to obtain device level information on the product supplied.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        388. Claim.item.detail.subDetail
                                        Definition

                                        A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                        ShortProduct or service provided
                                        Control0..*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        The items to be processed for adjudication.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        390. Claim.item.detail.subDetail.id
                                        Definition

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

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        392. Claim.item.detail.subDetail.extension
                                        Definition

                                        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.

                                        ShortAdditional content defined by implementations
                                        Comments

                                        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.

                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        394. Claim.item.detail.subDetail.modifierExtension
                                        Definition

                                        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).

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

                                        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.

                                        Control0..*
                                        TypeExtension
                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                        Summarytrue
                                        Requirements

                                        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.

                                        Alternate Namesextensions, user content, modifiers
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        396. Claim.item.detail.subDetail.sequence
                                        Definition

                                        A number to uniquely identify item entries.

                                        ShortItem instance identifier
                                        Control1..1
                                        TypepositiveInt
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        398. Claim.item.detail.subDetail.traceNumber
                                        Definition

                                        Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                        ShortNumber for tracking
                                        Control0..*
                                        TypeIdentifier
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Allows partners to uniquely identify components for tracking.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        400. Claim.item.detail.subDetail.revenue
                                        Definition

                                        The type of revenue or cost center providing the product and/or service.

                                        ShortRevenue or cost center code
                                        Control0..1
                                        BindingFor example codes, see ExampleRevenueCenterCodes
                                        (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                        Codes for the revenue or cost centers supplying the service and/or products.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Needed in the processing of institutional claims.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        402. Claim.item.detail.subDetail.category
                                        Definition

                                        Code to identify the general type of benefits under which products and services are provided.

                                        ShortBenefit classification
                                        Comments

                                        Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                        Control0..1
                                        BindingFor example codes, see BenefitCategoryCodes
                                        (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                        Benefit categories such as: oral-basic, major, glasses.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        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.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        404. Claim.item.detail.subDetail.productOrService
                                        Definition

                                        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.

                                        ShortBilling, service, product, or drug code
                                        Comments

                                        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'.

                                        Control0..1
                                        BindingFor example codes, see USCLSCodes
                                        (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                        Allowable service and product codes.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Necessary to state what was provided or done.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        406. Claim.item.detail.subDetail.productOrServiceEnd
                                        Definition

                                        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.

                                        ShortEnd of a range of codes
                                        Control0..1
                                        BindingFor example codes, see USCLSCodes
                                        (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        408. Claim.item.detail.subDetail.modifier
                                        Definition

                                        Item typification or modifiers codes to convey additional context for the product or service.

                                        ShortService/Product billing modifiers
                                        Comments

                                        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.

                                        Control0..*
                                        BindingFor example codes, see ModifierTypeCodes
                                        (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                        Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        To support inclusion of the item for adjudication or to charge an elevated fee.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        410. Claim.item.detail.subDetail.programCode
                                        Definition

                                        Identifies the program under which this may be recovered.

                                        ShortProgram the product or service is provided under
                                        Comments

                                        For example: Neonatal program, child dental program or drug users recovery program.

                                        Control0..*
                                        BindingFor example codes, see ExampleProgramReasonCodes
                                        (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                        Program specific reason codes.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        412. Claim.item.detail.subDetail.patientPaid
                                        Definition

                                        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.

                                        ShortPaid by the patient
                                        Control0..1
                                        TypeMoney
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        414. Claim.item.detail.subDetail.quantity
                                        Definition

                                        The number of repetitions of a service or product.

                                        ShortCount of products or services
                                        Control0..1
                                        TypeQuantity(SimpleQuantity)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Required when the product or service code does not convey the quantity provided.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        416. Claim.item.detail.subDetail.unitPrice
                                        Definition

                                        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.

                                        ShortFee, charge or cost per item
                                        Control0..1
                                        TypeMoney
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        The amount charged to the patient by the provider for a single unit.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        418. Claim.item.detail.subDetail.factor
                                        Definition

                                        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.

                                        ShortPrice scaling factor
                                        Comments

                                        To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                        Control0..1
                                        Typedecimal
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        420. Claim.item.detail.subDetail.tax
                                        Definition

                                        The total of taxes applicable for this product or service.

                                        ShortTotal tax
                                        Control0..1
                                        TypeMoney
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Required when taxes are not embedded in the unit price or provided as a separate service.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        422. Claim.item.detail.subDetail.net
                                        Definition

                                        The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                        ShortTotal item cost
                                        Comments

                                        For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                        Control0..1
                                        TypeMoney
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Provides the total amount claimed for the group (if a grouper) or the line item.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        424. Claim.item.detail.subDetail.udi
                                        Definition

                                        Unique Device Identifiers associated with this line item.

                                        ShortUnique device identifier
                                        Control0..*
                                        TypeReference(Device)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        The UDI code allows the insurer to obtain device level information on the product supplied.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        426. Claim.item:Leistungskomponente
                                        Slice NameLeistungskomponente
                                        Definition

                                        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.

                                        ShortProduct or service provided
                                        Control1..1
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        The items to be processed for adjudication.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        428. Claim.item:Leistungskomponente.id
                                        Definition

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

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        430. Claim.item:Leistungskomponente.extension
                                        Definition

                                        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.

                                        ShortAdditional content defined by implementations
                                        Comments

                                        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.

                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        432. Claim.item:Leistungskomponente.modifierExtension
                                        Definition

                                        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).

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

                                        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.

                                        Control0..*
                                        TypeExtension
                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                        Summarytrue
                                        Requirements

                                        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.

                                        Alternate Namesextensions, user content, modifiers
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        434. Claim.item:Leistungskomponente.sequence
                                        Definition

                                        A number to uniquely identify item entries.

                                        ShortItem instance identifier
                                        Control1..1
                                        TypepositiveInt
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        436. Claim.item:Leistungskomponente.traceNumber
                                        Definition

                                        Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                        ShortNumber for tracking
                                        Control0..*
                                        TypeIdentifier
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Allows partners to uniquely identify components for tracking.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        438. Claim.item:Leistungskomponente.careTeamSequence
                                        Definition

                                        CareTeam members related to this service or product.

                                        ShortApplicable careTeam members
                                        Control0..*
                                        TypepositiveInt
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Need to identify the individuals and their roles in the provision of the product or service.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        440. Claim.item:Leistungskomponente.diagnosisSequence
                                        Definition

                                        Diagnosis applicable for this service or product.

                                        ShortApplicable diagnoses
                                        Control0..*
                                        TypepositiveInt
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Need to related the product or service to the associated diagnoses.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        442. Claim.item:Leistungskomponente.procedureSequence
                                        Definition

                                        Procedures applicable for this service or product.

                                        ShortApplicable procedures
                                        Control0..*
                                        TypepositiveInt
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Need to provide any listed specific procedures to support the product or service being claimed.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        444. Claim.item:Leistungskomponente.informationSequence
                                        Definition

                                        Exceptions, special conditions and supporting information applicable for this service or product.

                                        ShortApplicable exception and supporting information
                                        Control0..*
                                        TypepositiveInt
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Need to reference the supporting information items that relate directly to this product or service.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        446. Claim.item:Leistungskomponente.revenue
                                        Definition

                                        The type of revenue or cost center providing the product and/or service.

                                        ShortRevenue or cost center code
                                        Control0..1
                                        BindingFor example codes, see ExampleRevenueCenterCodes
                                        (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                        Codes for the revenue or cost centers supplying the service and/or products.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Needed in the processing of institutional claims.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        448. Claim.item:Leistungskomponente.category
                                        Definition

                                        Code to identify the general type of benefits under which products and services are provided.

                                        ShortBenefit classification
                                        Comments

                                        Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                        Control0..1
                                        BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                        (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        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.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        450. Claim.item:Leistungskomponente.category.id
                                        Definition

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

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typeid
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        452. Claim.item:Leistungskomponente.category.extension
                                        Definition

                                        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.

                                        ShortAdditional content defined by implementations
                                        Comments

                                        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.

                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 454. Claim.item:Leistungskomponente.category.coding
                                          Definition

                                          A reference to a code defined by a terminology system.

                                          ShortCode defined by a terminology system
                                          Comments

                                          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.

                                          Control1..*
                                          TypeCoding
                                          Is Modifierfalse
                                          Summarytrue
                                          Requirements

                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                          Pattern Value{
                                            "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                            "code" : "LDFPLK"
                                          }
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          456. Claim.item:Leistungskomponente.category.text
                                          Definition

                                          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.

                                          ShortPlain text representation of the concept
                                          Comments

                                          Very often the text is the same as a displayName of one of the codings.

                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Requirements

                                          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.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          458. Claim.item:Leistungskomponente.productOrService
                                          Definition

                                          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.

                                          ShortBilling, service, product, or drug code
                                          Comments

                                          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'.

                                          Control0..1
                                          BindingFor example codes, see USCLSCodes
                                          (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                          Allowable service and product codes.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Necessary to state what was provided or done.

                                          Alternate NamesDrug Code, Bill Code, Service Code
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          460. Claim.item:Leistungskomponente.productOrServiceEnd
                                          Definition

                                          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.

                                          ShortEnd of a range of codes
                                          Control0..1
                                          BindingFor example codes, see USCLSCodes
                                          (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          462. Claim.item:Leistungskomponente.request
                                          Definition

                                          Request or Referral for Goods or Service to be rendered.

                                          ShortRequest or Referral for Service
                                          Control0..*
                                          TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          May identify the service to be provided or provider authorization for the service.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          464. Claim.item:Leistungskomponente.modifier
                                          Definition

                                          Item typification or modifiers codes to convey additional context for the product or service.

                                          ShortProduct or service billing modifiers
                                          Comments

                                          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.

                                          Control0..*
                                          BindingFor example codes, see ModifierTypeCodes
                                          (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                          Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          To support inclusion of the item for adjudication or to charge an elevated fee.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          466. Claim.item:Leistungskomponente.programCode
                                          Definition

                                          Identifies the program under which this may be recovered.

                                          ShortProgram the product or service is provided under
                                          Comments

                                          For example: Neonatal program, child dental program or drug users recovery program.

                                          Control0..*
                                          BindingFor example codes, see ExampleProgramReasonCodes
                                          (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                          Program specific reason codes.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          468. Claim.item:Leistungskomponente.serviced[x]
                                          Definition

                                          The date or dates when the service or product was supplied, performed or completed.

                                          ShortDate or dates of service or product delivery
                                          Control0..1
                                          TypeChoice of: date, Period
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          470. Claim.item:Leistungskomponente.location[x]
                                          Definition

                                          Where the product or service was provided.

                                          ShortPlace of service or where product was supplied
                                          Control0..1
                                          BindingFor example codes, see ExampleServicePlaceCodes
                                          (example to http://hl7.org/fhir/ValueSet/service-place)

                                          Place of service: pharmacy, school, prison, etc.

                                          TypeChoice of: CodeableConcept, Address, Reference(Location)
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          472. Claim.item:Leistungskomponente.patientPaid
                                          Definition

                                          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.

                                          ShortPaid by the patient
                                          Control0..1
                                          TypeMoney
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          474. Claim.item:Leistungskomponente.quantity
                                          Definition

                                          The number of repetitions of a service or product.

                                          ShortPunkteanzahl
                                          Control1..1
                                          TypeQuantity(SimpleQuantity)
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Required when the product or service code does not convey the quantity provided.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          476. Claim.item:Leistungskomponente.quantity.id
                                          Definition

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

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          Typeid
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          478. Claim.item:Leistungskomponente.quantity.extension
                                          Definition

                                          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.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 480. Claim.item:Leistungskomponente.quantity.value
                                            Definition

                                            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                            ShortNumerical value (with implicit precision)
                                            Comments

                                            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).

                                            Control0..1
                                            Typedecimal
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

                                            Precision is handled implicitly in almost all cases of measurement.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            482. Claim.item:Leistungskomponente.quantity.comparator
                                            Definition

                                            Not allowed to be used in this context

                                            Short< | <= | >= | > | ad - how to understand the value
                                            Control0..0
                                            BindingThe codes SHALL be taken from QuantityComparator
                                            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                            How the Quantity should be understood and represented.

                                            Typecode
                                            Is Modifiertrue because 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
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

                                            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                            Meaning if MissingIf there is no comparator, then there is no modification of the value
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            484. Claim.item:Leistungskomponente.quantity.unit
                                            Definition

                                            A human-readable form of the unit.

                                            ShortUnit representation
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

                                            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                            Pattern ValueLKF Punkte
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            486. Claim.item:Leistungskomponente.quantity.system
                                            Definition

                                            The identification of the system that provides the coded form of the unit.

                                            ShortSystem that defines coded unit form
                                            Control0..1
                                            This element is affected by the following invariants: qty-3
                                            Typeuri
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

                                            Need to know the system that defines the coded form of the unit.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            488. Claim.item:Leistungskomponente.quantity.code
                                            Definition

                                            A computer processable form of the unit in some unit representation system.

                                            ShortCoded form of the unit
                                            Comments

                                            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.

                                            Control0..1
                                            This element is affected by the following invariants: qty-3
                                            Typecode
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

                                            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.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            490. Claim.item:Leistungskomponente.unitPrice
                                            Definition

                                            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.

                                            ShortFee, charge or cost per item
                                            Control0..1
                                            TypeMoney
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            The amount charged to the patient by the provider for a single unit.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            492. Claim.item:Leistungskomponente.factor
                                            Definition

                                            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.

                                            ShortPrice scaling factor
                                            Comments

                                            To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                            Control0..1
                                            Typedecimal
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            494. Claim.item:Leistungskomponente.tax
                                            Definition

                                            The total of taxes applicable for this product or service.

                                            ShortTotal tax
                                            Control0..1
                                            TypeMoney
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Required when taxes are not embedded in the unit price or provided as a separate service.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            496. Claim.item:Leistungskomponente.net
                                            Definition

                                            The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                            ShortTotal item cost
                                            Comments

                                            For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                            Control0..1
                                            TypeMoney
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Provides the total amount claimed for the group (if a grouper) or the line item.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            498. Claim.item:Leistungskomponente.udi
                                            Definition

                                            Unique Device Identifiers associated with this line item.

                                            ShortUnique device identifier
                                            Control0..*
                                            TypeReference(Device)
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            The UDI code allows the insurer to obtain device level information on the product supplied.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            500. Claim.item:Leistungskomponente.bodySite
                                            Definition

                                            Physical location where the service is performed or applies.

                                            ShortAnatomical location
                                            Control0..*
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            502. Claim.item:Leistungskomponente.bodySite.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            504. Claim.item:Leistungskomponente.bodySite.extension
                                            Definition

                                            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.

                                            ShortAdditional content defined by implementations
                                            Comments

                                            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.

                                            Control0..*
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            506. Claim.item:Leistungskomponente.bodySite.modifierExtension
                                            Definition

                                            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).

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

                                            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.

                                            Control0..*
                                            TypeExtension
                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Summarytrue
                                            Requirements

                                            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.

                                            Alternate Namesextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            508. Claim.item:Leistungskomponente.bodySite.site
                                            Definition

                                            Physical service site on the patient (limb, tooth, etc.).

                                            ShortLocation
                                            Comments

                                            For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                            Control1..*
                                            BindingFor example codes, see OralSiteCodes
                                            (example to http://hl7.org/fhir/ValueSet/tooth)
                                            TypeCodeableReference(BodyStructure)
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Allows insurer to validate specific procedures.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            510. Claim.item:Leistungskomponente.bodySite.subSite
                                            Definition

                                            A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                            ShortSub-location
                                            Control0..*
                                            BindingFor example codes, see SurfaceCodes
                                            (example to http://hl7.org/fhir/ValueSet/surface)
                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Allows insurer to validate specific procedures.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            512. Claim.item:Leistungskomponente.encounter
                                            Definition

                                            Healthcare encounters related to this claim.

                                            ShortEncounters associated with the listed treatments
                                            Comments

                                            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.

                                            Control0..*
                                            TypeReference(Encounter)
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Used in some jurisdictions to link clinical events to claim items.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            514. Claim.item:Leistungskomponente.detail
                                            Definition

                                            A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                            ShortProduct or service provided
                                            Control0..*
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            The items to be processed for adjudication.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            516. Claim.item:Leistungskomponente.detail.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            518. Claim.item:Leistungskomponente.detail.extension
                                            Definition

                                            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.

                                            ShortAdditional content defined by implementations
                                            Comments

                                            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.

                                            Control0..*
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            520. Claim.item:Leistungskomponente.detail.modifierExtension
                                            Definition

                                            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).

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

                                            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.

                                            Control0..*
                                            TypeExtension
                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Summarytrue
                                            Requirements

                                            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.

                                            Alternate Namesextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            522. Claim.item:Leistungskomponente.detail.sequence
                                            Definition

                                            A number to uniquely identify item entries.

                                            ShortItem instance identifier
                                            Control1..1
                                            TypepositiveInt
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            524. Claim.item:Leistungskomponente.detail.traceNumber
                                            Definition

                                            Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                            ShortNumber for tracking
                                            Control0..*
                                            TypeIdentifier
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Allows partners to uniquely identify components for tracking.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            526. Claim.item:Leistungskomponente.detail.revenue
                                            Definition

                                            The type of revenue or cost center providing the product and/or service.

                                            ShortRevenue or cost center code
                                            Control0..1
                                            BindingFor example codes, see ExampleRevenueCenterCodes
                                            (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                            Codes for the revenue or cost centers supplying the service and/or products.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Needed in the processing of institutional claims.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            528. Claim.item:Leistungskomponente.detail.category
                                            Definition

                                            Code to identify the general type of benefits under which products and services are provided.

                                            ShortBenefit classification
                                            Comments

                                            Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                            Control0..1
                                            BindingFor example codes, see BenefitCategoryCodes
                                            (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                            Benefit categories such as: oral-basic, major, glasses.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            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.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            530. Claim.item:Leistungskomponente.detail.productOrService
                                            Definition

                                            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.

                                            ShortBilling, service, product, or drug code
                                            Comments

                                            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'.

                                            Control0..1
                                            BindingFor example codes, see USCLSCodes
                                            (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                            Allowable service and product codes.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Necessary to state what was provided or done.

                                            Alternate NamesDrug Code, Bill Code, Service Code
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            532. Claim.item:Leistungskomponente.detail.productOrServiceEnd
                                            Definition

                                            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.

                                            ShortEnd of a range of codes
                                            Control0..1
                                            BindingFor example codes, see USCLSCodes
                                            (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            534. Claim.item:Leistungskomponente.detail.modifier
                                            Definition

                                            Item typification or modifiers codes to convey additional context for the product or service.

                                            ShortService/Product billing modifiers
                                            Comments

                                            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.

                                            Control0..*
                                            BindingFor example codes, see ModifierTypeCodes
                                            (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                            Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            To support inclusion of the item for adjudication or to charge an elevated fee.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            536. Claim.item:Leistungskomponente.detail.programCode
                                            Definition

                                            Identifies the program under which this may be recovered.

                                            ShortProgram the product or service is provided under
                                            Comments

                                            For example: Neonatal program, child dental program or drug users recovery program.

                                            Control0..*
                                            BindingFor example codes, see ExampleProgramReasonCodes
                                            (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                            Program specific reason codes.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            538. Claim.item:Leistungskomponente.detail.patientPaid
                                            Definition

                                            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.

                                            ShortPaid by the patient
                                            Control0..1
                                            TypeMoney
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            540. Claim.item:Leistungskomponente.detail.quantity
                                            Definition

                                            The number of repetitions of a service or product.

                                            ShortCount of products or services
                                            Control0..1
                                            TypeQuantity(SimpleQuantity)
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Required when the product or service code does not convey the quantity provided.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            542. Claim.item:Leistungskomponente.detail.unitPrice
                                            Definition

                                            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.

                                            ShortFee, charge or cost per item
                                            Control0..1
                                            TypeMoney
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            The amount charged to the patient by the provider for a single unit.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            544. Claim.item:Leistungskomponente.detail.factor
                                            Definition

                                            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.

                                            ShortPrice scaling factor
                                            Comments

                                            To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                            Control0..1
                                            Typedecimal
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            546. Claim.item:Leistungskomponente.detail.tax
                                            Definition

                                            The total of taxes applicable for this product or service.

                                            ShortTotal tax
                                            Control0..1
                                            TypeMoney
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Required when taxes are not embedded in the unit price or provided as a separate service.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            548. Claim.item:Leistungskomponente.detail.net
                                            Definition

                                            The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                            ShortTotal item cost
                                            Comments

                                            For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                            Control0..1
                                            TypeMoney
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Provides the total amount claimed for the group (if a grouper) or the line item.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            550. Claim.item:Leistungskomponente.detail.udi
                                            Definition

                                            Unique Device Identifiers associated with this line item.

                                            ShortUnique device identifier
                                            Control0..*
                                            TypeReference(Device)
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            The UDI code allows the insurer to obtain device level information on the product supplied.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            552. Claim.item:Leistungskomponente.detail.subDetail
                                            Definition

                                            A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                            ShortProduct or service provided
                                            Control0..*
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            The items to be processed for adjudication.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            554. Claim.item:Leistungskomponente.detail.subDetail.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            556. Claim.item:Leistungskomponente.detail.subDetail.extension
                                            Definition

                                            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.

                                            ShortAdditional content defined by implementations
                                            Comments

                                            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.

                                            Control0..*
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            558. Claim.item:Leistungskomponente.detail.subDetail.modifierExtension
                                            Definition

                                            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).

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

                                            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.

                                            Control0..*
                                            TypeExtension
                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Summarytrue
                                            Requirements

                                            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.

                                            Alternate Namesextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            560. Claim.item:Leistungskomponente.detail.subDetail.sequence
                                            Definition

                                            A number to uniquely identify item entries.

                                            ShortItem instance identifier
                                            Control1..1
                                            TypepositiveInt
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            562. Claim.item:Leistungskomponente.detail.subDetail.traceNumber
                                            Definition

                                            Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                            ShortNumber for tracking
                                            Control0..*
                                            TypeIdentifier
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Allows partners to uniquely identify components for tracking.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            564. Claim.item:Leistungskomponente.detail.subDetail.revenue
                                            Definition

                                            The type of revenue or cost center providing the product and/or service.

                                            ShortRevenue or cost center code
                                            Control0..1
                                            BindingFor example codes, see ExampleRevenueCenterCodes
                                            (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                            Codes for the revenue or cost centers supplying the service and/or products.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Needed in the processing of institutional claims.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            566. Claim.item:Leistungskomponente.detail.subDetail.category
                                            Definition

                                            Code to identify the general type of benefits under which products and services are provided.

                                            ShortBenefit classification
                                            Comments

                                            Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                            Control0..1
                                            BindingFor example codes, see BenefitCategoryCodes
                                            (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                            Benefit categories such as: oral-basic, major, glasses.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            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.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            568. Claim.item:Leistungskomponente.detail.subDetail.productOrService
                                            Definition

                                            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.

                                            ShortBilling, service, product, or drug code
                                            Comments

                                            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'.

                                            Control0..1
                                            BindingFor example codes, see USCLSCodes
                                            (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                            Allowable service and product codes.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Necessary to state what was provided or done.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            570. Claim.item:Leistungskomponente.detail.subDetail.productOrServiceEnd
                                            Definition

                                            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.

                                            ShortEnd of a range of codes
                                            Control0..1
                                            BindingFor example codes, see USCLSCodes
                                            (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            572. Claim.item:Leistungskomponente.detail.subDetail.modifier
                                            Definition

                                            Item typification or modifiers codes to convey additional context for the product or service.

                                            ShortService/Product billing modifiers
                                            Comments

                                            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.

                                            Control0..*
                                            BindingFor example codes, see ModifierTypeCodes
                                            (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                            Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            To support inclusion of the item for adjudication or to charge an elevated fee.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            574. Claim.item:Leistungskomponente.detail.subDetail.programCode
                                            Definition

                                            Identifies the program under which this may be recovered.

                                            ShortProgram the product or service is provided under
                                            Comments

                                            For example: Neonatal program, child dental program or drug users recovery program.

                                            Control0..*
                                            BindingFor example codes, see ExampleProgramReasonCodes
                                            (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                            Program specific reason codes.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            576. Claim.item:Leistungskomponente.detail.subDetail.patientPaid
                                            Definition

                                            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.

                                            ShortPaid by the patient
                                            Control0..1
                                            TypeMoney
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            578. Claim.item:Leistungskomponente.detail.subDetail.quantity
                                            Definition

                                            The number of repetitions of a service or product.

                                            ShortCount of products or services
                                            Control0..1
                                            TypeQuantity(SimpleQuantity)
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Required when the product or service code does not convey the quantity provided.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            580. Claim.item:Leistungskomponente.detail.subDetail.unitPrice
                                            Definition

                                            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.

                                            ShortFee, charge or cost per item
                                            Control0..1
                                            TypeMoney
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            The amount charged to the patient by the provider for a single unit.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            582. Claim.item:Leistungskomponente.detail.subDetail.factor
                                            Definition

                                            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.

                                            ShortPrice scaling factor
                                            Comments

                                            To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                            Control0..1
                                            Typedecimal
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            584. Claim.item:Leistungskomponente.detail.subDetail.tax
                                            Definition

                                            The total of taxes applicable for this product or service.

                                            ShortTotal tax
                                            Control0..1
                                            TypeMoney
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Required when taxes are not embedded in the unit price or provided as a separate service.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            586. Claim.item:Leistungskomponente.detail.subDetail.net
                                            Definition

                                            The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                            ShortTotal item cost
                                            Comments

                                            For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                            Control0..1
                                            TypeMoney
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Provides the total amount claimed for the group (if a grouper) or the line item.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            588. Claim.item:Leistungskomponente.detail.subDetail.udi
                                            Definition

                                            Unique Device Identifiers associated with this line item.

                                            ShortUnique device identifier
                                            Control0..*
                                            TypeReference(Device)
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            The UDI code allows the insurer to obtain device level information on the product supplied.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            590. Claim.item:Tageskomponente
                                            Slice NameTageskomponente
                                            Definition

                                            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.

                                            ShortProduct or service provided
                                            Control1..1
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            The items to be processed for adjudication.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            592. Claim.item:Tageskomponente.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            594. Claim.item:Tageskomponente.extension
                                            Definition

                                            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.

                                            ShortAdditional content defined by implementations
                                            Comments

                                            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.

                                            Control0..*
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            596. Claim.item:Tageskomponente.modifierExtension
                                            Definition

                                            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).

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

                                            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.

                                            Control0..*
                                            TypeExtension
                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Summarytrue
                                            Requirements

                                            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.

                                            Alternate Namesextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            598. Claim.item:Tageskomponente.sequence
                                            Definition

                                            A number to uniquely identify item entries.

                                            ShortItem instance identifier
                                            Control1..1
                                            TypepositiveInt
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            600. Claim.item:Tageskomponente.traceNumber
                                            Definition

                                            Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                            ShortNumber for tracking
                                            Control0..*
                                            TypeIdentifier
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Allows partners to uniquely identify components for tracking.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            602. Claim.item:Tageskomponente.careTeamSequence
                                            Definition

                                            CareTeam members related to this service or product.

                                            ShortApplicable careTeam members
                                            Control0..*
                                            TypepositiveInt
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Need to identify the individuals and their roles in the provision of the product or service.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            604. Claim.item:Tageskomponente.diagnosisSequence
                                            Definition

                                            Diagnosis applicable for this service or product.

                                            ShortApplicable diagnoses
                                            Control0..*
                                            TypepositiveInt
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Need to related the product or service to the associated diagnoses.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            606. Claim.item:Tageskomponente.procedureSequence
                                            Definition

                                            Procedures applicable for this service or product.

                                            ShortApplicable procedures
                                            Control0..*
                                            TypepositiveInt
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Need to provide any listed specific procedures to support the product or service being claimed.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            608. Claim.item:Tageskomponente.informationSequence
                                            Definition

                                            Exceptions, special conditions and supporting information applicable for this service or product.

                                            ShortApplicable exception and supporting information
                                            Control0..*
                                            TypepositiveInt
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Need to reference the supporting information items that relate directly to this product or service.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            610. Claim.item:Tageskomponente.revenue
                                            Definition

                                            The type of revenue or cost center providing the product and/or service.

                                            ShortRevenue or cost center code
                                            Control0..1
                                            BindingFor example codes, see ExampleRevenueCenterCodes
                                            (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                            Codes for the revenue or cost centers supplying the service and/or products.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Needed in the processing of institutional claims.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            612. Claim.item:Tageskomponente.category
                                            Definition

                                            Code to identify the general type of benefits under which products and services are provided.

                                            ShortBenefit classification
                                            Comments

                                            Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                            Control0..1
                                            BindingFor example codes, see BenefitCategoryCodes
                                            (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                            Benefit categories such as: oral-basic, major, glasses.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            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.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            614. Claim.item:Tageskomponente.category.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            Typeid
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            616. Claim.item:Tageskomponente.category.extension
                                            Definition

                                            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.

                                            ShortAdditional content defined by implementations
                                            Comments

                                            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.

                                            Control0..*
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 618. Claim.item:Tageskomponente.category.coding
                                              Definition

                                              A reference to a code defined by a terminology system.

                                              ShortCode defined by a terminology system
                                              Comments

                                              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.

                                              Control1..*
                                              BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                              (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                              TypeCoding
                                              Is Modifierfalse
                                              Summarytrue
                                              Requirements

                                              Allows for alternative encodings within a code system, and translations to other code systems.

                                              Pattern Value{
                                                "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                                "code" : "LDFPTK"
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              620. Claim.item:Tageskomponente.category.text
                                              Definition

                                              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.

                                              ShortPlain text representation of the concept
                                              Comments

                                              Very often the text is the same as a displayName of one of the codings.

                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              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.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              622. Claim.item:Tageskomponente.productOrService
                                              Definition

                                              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.

                                              ShortBilling, service, product, or drug code
                                              Comments

                                              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'.

                                              Control0..1
                                              BindingFor example codes, see USCLSCodes
                                              (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                              Allowable service and product codes.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Necessary to state what was provided or done.

                                              Alternate NamesDrug Code, Bill Code, Service Code
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              624. Claim.item:Tageskomponente.productOrServiceEnd
                                              Definition

                                              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.

                                              ShortEnd of a range of codes
                                              Control0..1
                                              BindingFor example codes, see USCLSCodes
                                              (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              626. Claim.item:Tageskomponente.request
                                              Definition

                                              Request or Referral for Goods or Service to be rendered.

                                              ShortRequest or Referral for Service
                                              Control0..*
                                              TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              May identify the service to be provided or provider authorization for the service.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              628. Claim.item:Tageskomponente.modifier
                                              Definition

                                              Item typification or modifiers codes to convey additional context for the product or service.

                                              ShortProduct or service billing modifiers
                                              Comments

                                              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.

                                              Control0..*
                                              BindingFor example codes, see ModifierTypeCodes
                                              (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                              Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              To support inclusion of the item for adjudication or to charge an elevated fee.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              630. Claim.item:Tageskomponente.programCode
                                              Definition

                                              Identifies the program under which this may be recovered.

                                              ShortProgram the product or service is provided under
                                              Comments

                                              For example: Neonatal program, child dental program or drug users recovery program.

                                              Control0..*
                                              BindingFor example codes, see ExampleProgramReasonCodes
                                              (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                              Program specific reason codes.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              632. Claim.item:Tageskomponente.serviced[x]
                                              Definition

                                              The date or dates when the service or product was supplied, performed or completed.

                                              ShortDate or dates of service or product delivery
                                              Control0..1
                                              TypeChoice of: date, Period
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              634. Claim.item:Tageskomponente.location[x]
                                              Definition

                                              Where the product or service was provided.

                                              ShortPlace of service or where product was supplied
                                              Control0..1
                                              BindingFor example codes, see ExampleServicePlaceCodes
                                              (example to http://hl7.org/fhir/ValueSet/service-place)

                                              Place of service: pharmacy, school, prison, etc.

                                              TypeChoice of: CodeableConcept, Address, Reference(Location)
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              636. Claim.item:Tageskomponente.patientPaid
                                              Definition

                                              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.

                                              ShortPaid by the patient
                                              Control0..1
                                              TypeMoney
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              638. Claim.item:Tageskomponente.quantity
                                              Definition

                                              The number of repetitions of a service or product.

                                              ShortPunkteanzahl
                                              Control1..1
                                              TypeQuantity(SimpleQuantity)
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Required when the product or service code does not convey the quantity provided.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              640. Claim.item:Tageskomponente.quantity.id
                                              Definition

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

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              Typeid
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              642. Claim.item:Tageskomponente.quantity.extension
                                              Definition

                                              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.

                                              ShortAdditional content defined by implementations
                                              Comments

                                              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.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 644. Claim.item:Tageskomponente.quantity.value
                                                Definition

                                                The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                ShortNumerical value (with implicit precision)
                                                Comments

                                                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).

                                                Control1..1
                                                Typedecimal
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                Precision is handled implicitly in almost all cases of measurement.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                646. Claim.item:Tageskomponente.quantity.comparator
                                                Definition

                                                Not allowed to be used in this context

                                                Short< | <= | >= | > | ad - how to understand the value
                                                Control0..0
                                                BindingThe codes SHALL be taken from QuantityComparator
                                                (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                                How the Quantity should be understood and represented.

                                                Typecode
                                                Is Modifiertrue because 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
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                648. Claim.item:Tageskomponente.quantity.unit
                                                Definition

                                                A human-readable form of the unit.

                                                ShortUnit representation
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                Pattern ValueLKF Punkte
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                650. Claim.item:Tageskomponente.quantity.system
                                                Definition

                                                The identification of the system that provides the coded form of the unit.

                                                ShortSystem that defines coded unit form
                                                Control0..1
                                                This element is affected by the following invariants: qty-3
                                                Typeuri
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                Need to know the system that defines the coded form of the unit.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                652. Claim.item:Tageskomponente.quantity.code
                                                Definition

                                                A computer processable form of the unit in some unit representation system.

                                                ShortCoded form of the unit
                                                Comments

                                                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.

                                                Control0..1
                                                This element is affected by the following invariants: qty-3
                                                Typecode
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                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.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                654. Claim.item:Tageskomponente.unitPrice
                                                Definition

                                                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.

                                                ShortFee, charge or cost per item
                                                Control0..1
                                                TypeMoney
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                The amount charged to the patient by the provider for a single unit.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                656. Claim.item:Tageskomponente.factor
                                                Definition

                                                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.

                                                ShortPrice scaling factor
                                                Comments

                                                To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                Control0..1
                                                Typedecimal
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                658. Claim.item:Tageskomponente.tax
                                                Definition

                                                The total of taxes applicable for this product or service.

                                                ShortTotal tax
                                                Control0..1
                                                TypeMoney
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Required when taxes are not embedded in the unit price or provided as a separate service.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                660. Claim.item:Tageskomponente.net
                                                Definition

                                                The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                                ShortTotal item cost
                                                Comments

                                                For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                Control0..1
                                                TypeMoney
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Provides the total amount claimed for the group (if a grouper) or the line item.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                662. Claim.item:Tageskomponente.udi
                                                Definition

                                                Unique Device Identifiers associated with this line item.

                                                ShortUnique device identifier
                                                Control0..*
                                                TypeReference(Device)
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                The UDI code allows the insurer to obtain device level information on the product supplied.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                664. Claim.item:Tageskomponente.bodySite
                                                Definition

                                                Physical location where the service is performed or applies.

                                                ShortAnatomical location
                                                Control0..*
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                666. Claim.item:Tageskomponente.bodySite.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                668. Claim.item:Tageskomponente.bodySite.extension
                                                Definition

                                                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.

                                                ShortAdditional content defined by implementations
                                                Comments

                                                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.

                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                670. Claim.item:Tageskomponente.bodySite.modifierExtension
                                                Definition

                                                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).

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

                                                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.

                                                Control0..*
                                                TypeExtension
                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                Summarytrue
                                                Requirements

                                                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.

                                                Alternate Namesextensions, user content, modifiers
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                672. Claim.item:Tageskomponente.bodySite.site
                                                Definition

                                                Physical service site on the patient (limb, tooth, etc.).

                                                ShortLocation
                                                Comments

                                                For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                                Control1..*
                                                BindingFor example codes, see OralSiteCodes
                                                (example to http://hl7.org/fhir/ValueSet/tooth)
                                                TypeCodeableReference(BodyStructure)
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Allows insurer to validate specific procedures.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                674. Claim.item:Tageskomponente.bodySite.subSite
                                                Definition

                                                A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                                ShortSub-location
                                                Control0..*
                                                BindingFor example codes, see SurfaceCodes
                                                (example to http://hl7.org/fhir/ValueSet/surface)
                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Allows insurer to validate specific procedures.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                676. Claim.item:Tageskomponente.encounter
                                                Definition

                                                Healthcare encounters related to this claim.

                                                ShortEncounters associated with the listed treatments
                                                Comments

                                                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.

                                                Control0..*
                                                TypeReference(Encounter)
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Used in some jurisdictions to link clinical events to claim items.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                678. Claim.item:Tageskomponente.detail
                                                Definition

                                                A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                ShortProduct or service provided
                                                Control0..*
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                The items to be processed for adjudication.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                680. Claim.item:Tageskomponente.detail.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                682. Claim.item:Tageskomponente.detail.extension
                                                Definition

                                                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.

                                                ShortAdditional content defined by implementations
                                                Comments

                                                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.

                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                684. Claim.item:Tageskomponente.detail.modifierExtension
                                                Definition

                                                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).

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

                                                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.

                                                Control0..*
                                                TypeExtension
                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                Summarytrue
                                                Requirements

                                                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.

                                                Alternate Namesextensions, user content, modifiers
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                686. Claim.item:Tageskomponente.detail.sequence
                                                Definition

                                                A number to uniquely identify item entries.

                                                ShortItem instance identifier
                                                Control1..1
                                                TypepositiveInt
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                688. Claim.item:Tageskomponente.detail.traceNumber
                                                Definition

                                                Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                ShortNumber for tracking
                                                Control0..*
                                                TypeIdentifier
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Allows partners to uniquely identify components for tracking.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                690. Claim.item:Tageskomponente.detail.revenue
                                                Definition

                                                The type of revenue or cost center providing the product and/or service.

                                                ShortRevenue or cost center code
                                                Control0..1
                                                BindingFor example codes, see ExampleRevenueCenterCodes
                                                (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                Codes for the revenue or cost centers supplying the service and/or products.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Needed in the processing of institutional claims.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                692. Claim.item:Tageskomponente.detail.category
                                                Definition

                                                Code to identify the general type of benefits under which products and services are provided.

                                                ShortBenefit classification
                                                Comments

                                                Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                Control0..1
                                                BindingFor example codes, see BenefitCategoryCodes
                                                (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                Benefit categories such as: oral-basic, major, glasses.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                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.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                694. Claim.item:Tageskomponente.detail.productOrService
                                                Definition

                                                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.

                                                ShortBilling, service, product, or drug code
                                                Comments

                                                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'.

                                                Control0..1
                                                BindingFor example codes, see USCLSCodes
                                                (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                Allowable service and product codes.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Necessary to state what was provided or done.

                                                Alternate NamesDrug Code, Bill Code, Service Code
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                696. Claim.item:Tageskomponente.detail.productOrServiceEnd
                                                Definition

                                                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.

                                                ShortEnd of a range of codes
                                                Control0..1
                                                BindingFor example codes, see USCLSCodes
                                                (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                698. Claim.item:Tageskomponente.detail.modifier
                                                Definition

                                                Item typification or modifiers codes to convey additional context for the product or service.

                                                ShortService/Product billing modifiers
                                                Comments

                                                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.

                                                Control0..*
                                                BindingFor example codes, see ModifierTypeCodes
                                                (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                To support inclusion of the item for adjudication or to charge an elevated fee.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                700. Claim.item:Tageskomponente.detail.programCode
                                                Definition

                                                Identifies the program under which this may be recovered.

                                                ShortProgram the product or service is provided under
                                                Comments

                                                For example: Neonatal program, child dental program or drug users recovery program.

                                                Control0..*
                                                BindingFor example codes, see ExampleProgramReasonCodes
                                                (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                Program specific reason codes.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                702. Claim.item:Tageskomponente.detail.patientPaid
                                                Definition

                                                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.

                                                ShortPaid by the patient
                                                Control0..1
                                                TypeMoney
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                704. Claim.item:Tageskomponente.detail.quantity
                                                Definition

                                                The number of repetitions of a service or product.

                                                ShortCount of products or services
                                                Control0..1
                                                TypeQuantity(SimpleQuantity)
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Required when the product or service code does not convey the quantity provided.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                706. Claim.item:Tageskomponente.detail.unitPrice
                                                Definition

                                                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.

                                                ShortFee, charge or cost per item
                                                Control0..1
                                                TypeMoney
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                The amount charged to the patient by the provider for a single unit.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                708. Claim.item:Tageskomponente.detail.factor
                                                Definition

                                                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.

                                                ShortPrice scaling factor
                                                Comments

                                                To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                Control0..1
                                                Typedecimal
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                710. Claim.item:Tageskomponente.detail.tax
                                                Definition

                                                The total of taxes applicable for this product or service.

                                                ShortTotal tax
                                                Control0..1
                                                TypeMoney
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Required when taxes are not embedded in the unit price or provided as a separate service.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                712. Claim.item:Tageskomponente.detail.net
                                                Definition

                                                The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                                ShortTotal item cost
                                                Comments

                                                For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                Control0..1
                                                TypeMoney
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Provides the total amount claimed for the group (if a grouper) or the line item.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                714. Claim.item:Tageskomponente.detail.udi
                                                Definition

                                                Unique Device Identifiers associated with this line item.

                                                ShortUnique device identifier
                                                Control0..*
                                                TypeReference(Device)
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                The UDI code allows the insurer to obtain device level information on the product supplied.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                716. Claim.item:Tageskomponente.detail.subDetail
                                                Definition

                                                A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                ShortProduct or service provided
                                                Control0..*
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                The items to be processed for adjudication.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                718. Claim.item:Tageskomponente.detail.subDetail.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                720. Claim.item:Tageskomponente.detail.subDetail.extension
                                                Definition

                                                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.

                                                ShortAdditional content defined by implementations
                                                Comments

                                                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.

                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                722. Claim.item:Tageskomponente.detail.subDetail.modifierExtension
                                                Definition

                                                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).

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

                                                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.

                                                Control0..*
                                                TypeExtension
                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                Summarytrue
                                                Requirements

                                                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.

                                                Alternate Namesextensions, user content, modifiers
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                724. Claim.item:Tageskomponente.detail.subDetail.sequence
                                                Definition

                                                A number to uniquely identify item entries.

                                                ShortItem instance identifier
                                                Control1..1
                                                TypepositiveInt
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                726. Claim.item:Tageskomponente.detail.subDetail.traceNumber
                                                Definition

                                                Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                ShortNumber for tracking
                                                Control0..*
                                                TypeIdentifier
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Allows partners to uniquely identify components for tracking.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                728. Claim.item:Tageskomponente.detail.subDetail.revenue
                                                Definition

                                                The type of revenue or cost center providing the product and/or service.

                                                ShortRevenue or cost center code
                                                Control0..1
                                                BindingFor example codes, see ExampleRevenueCenterCodes
                                                (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                Codes for the revenue or cost centers supplying the service and/or products.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Needed in the processing of institutional claims.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                730. Claim.item:Tageskomponente.detail.subDetail.category
                                                Definition

                                                Code to identify the general type of benefits under which products and services are provided.

                                                ShortBenefit classification
                                                Comments

                                                Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                Control0..1
                                                BindingFor example codes, see BenefitCategoryCodes
                                                (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                Benefit categories such as: oral-basic, major, glasses.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                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.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                732. Claim.item:Tageskomponente.detail.subDetail.productOrService
                                                Definition

                                                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.

                                                ShortBilling, service, product, or drug code
                                                Comments

                                                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'.

                                                Control0..1
                                                BindingFor example codes, see USCLSCodes
                                                (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                Allowable service and product codes.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Necessary to state what was provided or done.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                734. Claim.item:Tageskomponente.detail.subDetail.productOrServiceEnd
                                                Definition

                                                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.

                                                ShortEnd of a range of codes
                                                Control0..1
                                                BindingFor example codes, see USCLSCodes
                                                (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                736. Claim.item:Tageskomponente.detail.subDetail.modifier
                                                Definition

                                                Item typification or modifiers codes to convey additional context for the product or service.

                                                ShortService/Product billing modifiers
                                                Comments

                                                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.

                                                Control0..*
                                                BindingFor example codes, see ModifierTypeCodes
                                                (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                To support inclusion of the item for adjudication or to charge an elevated fee.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                738. Claim.item:Tageskomponente.detail.subDetail.programCode
                                                Definition

                                                Identifies the program under which this may be recovered.

                                                ShortProgram the product or service is provided under
                                                Comments

                                                For example: Neonatal program, child dental program or drug users recovery program.

                                                Control0..*
                                                BindingFor example codes, see ExampleProgramReasonCodes
                                                (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                Program specific reason codes.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                740. Claim.item:Tageskomponente.detail.subDetail.patientPaid
                                                Definition

                                                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.

                                                ShortPaid by the patient
                                                Control0..1
                                                TypeMoney
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                742. Claim.item:Tageskomponente.detail.subDetail.quantity
                                                Definition

                                                The number of repetitions of a service or product.

                                                ShortCount of products or services
                                                Control0..1
                                                TypeQuantity(SimpleQuantity)
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Required when the product or service code does not convey the quantity provided.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                744. Claim.item:Tageskomponente.detail.subDetail.unitPrice
                                                Definition

                                                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.

                                                ShortFee, charge or cost per item
                                                Control0..1
                                                TypeMoney
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                The amount charged to the patient by the provider for a single unit.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                746. Claim.item:Tageskomponente.detail.subDetail.factor
                                                Definition

                                                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.

                                                ShortPrice scaling factor
                                                Comments

                                                To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                Control0..1
                                                Typedecimal
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                748. Claim.item:Tageskomponente.detail.subDetail.tax
                                                Definition

                                                The total of taxes applicable for this product or service.

                                                ShortTotal tax
                                                Control0..1
                                                TypeMoney
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Required when taxes are not embedded in the unit price or provided as a separate service.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                750. Claim.item:Tageskomponente.detail.subDetail.net
                                                Definition

                                                The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                                ShortTotal item cost
                                                Comments

                                                For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                Control0..1
                                                TypeMoney
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Provides the total amount claimed for the group (if a grouper) or the line item.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                752. Claim.item:Tageskomponente.detail.subDetail.udi
                                                Definition

                                                Unique Device Identifiers associated with this line item.

                                                ShortUnique device identifier
                                                Control0..*
                                                TypeReference(Device)
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                The UDI code allows the insurer to obtain device level information on the product supplied.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                754. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente
                                                Slice NamePunkteBelagsdauerausreisserUntenLeistungskomponente
                                                Definition

                                                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.

                                                ShortProduct or service provided
                                                Control0..1
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                The items to be processed for adjudication.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                756. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                758. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.extension
                                                Definition

                                                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.

                                                ShortAdditional content defined by implementations
                                                Comments

                                                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.

                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                760. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.modifierExtension
                                                Definition

                                                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).

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

                                                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.

                                                Control0..*
                                                TypeExtension
                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                Summarytrue
                                                Requirements

                                                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.

                                                Alternate Namesextensions, user content, modifiers
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                762. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.sequence
                                                Definition

                                                A number to uniquely identify item entries.

                                                ShortItem instance identifier
                                                Control1..1
                                                TypepositiveInt
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                764. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.traceNumber
                                                Definition

                                                Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                ShortNumber for tracking
                                                Control0..*
                                                TypeIdentifier
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Allows partners to uniquely identify components for tracking.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                766. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.careTeamSequence
                                                Definition

                                                CareTeam members related to this service or product.

                                                ShortApplicable careTeam members
                                                Control0..*
                                                TypepositiveInt
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Need to identify the individuals and their roles in the provision of the product or service.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                768. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.diagnosisSequence
                                                Definition

                                                Diagnosis applicable for this service or product.

                                                ShortApplicable diagnoses
                                                Control0..*
                                                TypepositiveInt
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Need to related the product or service to the associated diagnoses.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                770. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.procedureSequence
                                                Definition

                                                Procedures applicable for this service or product.

                                                ShortApplicable procedures
                                                Control0..*
                                                TypepositiveInt
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Need to provide any listed specific procedures to support the product or service being claimed.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                772. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.informationSequence
                                                Definition

                                                Exceptions, special conditions and supporting information applicable for this service or product.

                                                ShortApplicable exception and supporting information
                                                Control0..*
                                                TypepositiveInt
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Need to reference the supporting information items that relate directly to this product or service.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                774. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.revenue
                                                Definition

                                                The type of revenue or cost center providing the product and/or service.

                                                ShortRevenue or cost center code
                                                Control0..1
                                                BindingFor example codes, see ExampleRevenueCenterCodes
                                                (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                Codes for the revenue or cost centers supplying the service and/or products.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Needed in the processing of institutional claims.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                776. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.category
                                                Definition

                                                Code to identify the general type of benefits under which products and services are provided.

                                                ShortBenefit classification
                                                Comments

                                                Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                Control0..1
                                                BindingFor example codes, see BenefitCategoryCodes
                                                (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                Benefit categories such as: oral-basic, major, glasses.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                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.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                778. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.category.id
                                                Definition

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                Typeid
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                780. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.category.extension
                                                Definition

                                                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.

                                                ShortAdditional content defined by implementations
                                                Comments

                                                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.

                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 782. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.category.coding
                                                  Definition

                                                  A reference to a code defined by a terminology system.

                                                  ShortCode defined by a terminology system
                                                  Comments

                                                  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.

                                                  Control1..*
                                                  BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                                  (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                                  TypeCoding
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Requirements

                                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                                  Pattern Value{
                                                    "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                                    "code" : "SCULK"
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  784. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.category.text
                                                  Definition

                                                  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.

                                                  ShortPlain text representation of the concept
                                                  Comments

                                                  Very often the text is the same as a displayName of one of the codings.

                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

                                                  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.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  786. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.productOrService
                                                  Definition

                                                  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.

                                                  ShortBilling, service, product, or drug code
                                                  Comments

                                                  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'.

                                                  Control0..1
                                                  BindingFor example codes, see USCLSCodes
                                                  (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                  Allowable service and product codes.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Necessary to state what was provided or done.

                                                  Alternate NamesDrug Code, Bill Code, Service Code
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  788. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.productOrServiceEnd
                                                  Definition

                                                  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.

                                                  ShortEnd of a range of codes
                                                  Control0..1
                                                  BindingFor example codes, see USCLSCodes
                                                  (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  790. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.request
                                                  Definition

                                                  Request or Referral for Goods or Service to be rendered.

                                                  ShortRequest or Referral for Service
                                                  Control0..*
                                                  TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  May identify the service to be provided or provider authorization for the service.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  792. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.modifier
                                                  Definition

                                                  Item typification or modifiers codes to convey additional context for the product or service.

                                                  ShortProduct or service billing modifiers
                                                  Comments

                                                  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.

                                                  Control0..*
                                                  BindingFor example codes, see ModifierTypeCodes
                                                  (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                  Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  To support inclusion of the item for adjudication or to charge an elevated fee.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  794. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.programCode
                                                  Definition

                                                  Identifies the program under which this may be recovered.

                                                  ShortProgram the product or service is provided under
                                                  Comments

                                                  For example: Neonatal program, child dental program or drug users recovery program.

                                                  Control0..*
                                                  BindingFor example codes, see ExampleProgramReasonCodes
                                                  (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                  Program specific reason codes.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  796. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.serviced[x]
                                                  Definition

                                                  The date or dates when the service or product was supplied, performed or completed.

                                                  ShortDate or dates of service or product delivery
                                                  Control0..1
                                                  TypeChoice of: date, Period
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  798. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.location[x]
                                                  Definition

                                                  Where the product or service was provided.

                                                  ShortPlace of service or where product was supplied
                                                  Control0..1
                                                  BindingFor example codes, see ExampleServicePlaceCodes
                                                  (example to http://hl7.org/fhir/ValueSet/service-place)

                                                  Place of service: pharmacy, school, prison, etc.

                                                  TypeChoice of: CodeableConcept, Address, Reference(Location)
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  800. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.patientPaid
                                                  Definition

                                                  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.

                                                  ShortPaid by the patient
                                                  Control0..1
                                                  TypeMoney
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  802. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity
                                                  Definition

                                                  The number of repetitions of a service or product.

                                                  ShortPunkteanzahl
                                                  Control1..1
                                                  TypeQuantity(SimpleQuantity)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Required when the product or service code does not convey the quantity provided.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  804. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.id
                                                  Definition

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

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typeid
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  806. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.extension
                                                  Definition

                                                  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.

                                                  ShortAdditional content defined by implementations
                                                  Comments

                                                  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.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Alternate Namesextensions, user content
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 808. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.value
                                                    Definition

                                                    The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                    ShortNumerical value (with implicit precision)
                                                    Comments

                                                    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).

                                                    Control1..1
                                                    Typedecimal
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Requirements

                                                    Precision is handled implicitly in almost all cases of measurement.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    810. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.comparator
                                                    Definition

                                                    Not allowed to be used in this context

                                                    Short< | <= | >= | > | ad - how to understand the value
                                                    Control0..0
                                                    BindingThe codes SHALL be taken from QuantityComparator
                                                    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                                    How the Quantity should be understood and represented.

                                                    Typecode
                                                    Is Modifiertrue because 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
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Requirements

                                                    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                    Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    812. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.unit
                                                    Definition

                                                    A human-readable form of the unit.

                                                    ShortUnit representation
                                                    Control0..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Requirements

                                                    There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                    Pattern ValueLKF Punkte
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    814. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.system
                                                    Definition

                                                    The identification of the system that provides the coded form of the unit.

                                                    ShortSystem that defines coded unit form
                                                    Control0..1
                                                    This element is affected by the following invariants: qty-3
                                                    Typeuri
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Requirements

                                                    Need to know the system that defines the coded form of the unit.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    816. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.code
                                                    Definition

                                                    A computer processable form of the unit in some unit representation system.

                                                    ShortCoded form of the unit
                                                    Comments

                                                    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.

                                                    Control0..1
                                                    This element is affected by the following invariants: qty-3
                                                    Typecode
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Requirements

                                                    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.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    818. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.unitPrice
                                                    Definition

                                                    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.

                                                    ShortFee, charge or cost per item
                                                    Control0..1
                                                    TypeMoney
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    The amount charged to the patient by the provider for a single unit.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    820. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.factor
                                                    Definition

                                                    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.

                                                    ShortPrice scaling factor
                                                    Comments

                                                    To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                    Control0..1
                                                    Typedecimal
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    822. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.tax
                                                    Definition

                                                    The total of taxes applicable for this product or service.

                                                    ShortTotal tax
                                                    Control0..1
                                                    TypeMoney
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Required when taxes are not embedded in the unit price or provided as a separate service.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    824. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.net
                                                    Definition

                                                    The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                                    ShortTotal item cost
                                                    Comments

                                                    For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                    Control0..1
                                                    TypeMoney
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Provides the total amount claimed for the group (if a grouper) or the line item.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    826. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.udi
                                                    Definition

                                                    Unique Device Identifiers associated with this line item.

                                                    ShortUnique device identifier
                                                    Control0..*
                                                    TypeReference(Device)
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    The UDI code allows the insurer to obtain device level information on the product supplied.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    828. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.bodySite
                                                    Definition

                                                    Physical location where the service is performed or applies.

                                                    ShortAnatomical location
                                                    Control0..*
                                                    TypeBackboneElement
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    830. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.bodySite.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    Typestring
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    832. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.bodySite.extension
                                                    Definition

                                                    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.

                                                    ShortAdditional content defined by implementations
                                                    Comments

                                                    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.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    834. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.bodySite.modifierExtension
                                                    Definition

                                                    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).

                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                    Comments

                                                    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.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                    Summarytrue
                                                    Requirements

                                                    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.

                                                    Alternate Namesextensions, user content, modifiers
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    836. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.bodySite.site
                                                    Definition

                                                    Physical service site on the patient (limb, tooth, etc.).

                                                    ShortLocation
                                                    Comments

                                                    For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                                    Control1..*
                                                    BindingFor example codes, see OralSiteCodes
                                                    (example to http://hl7.org/fhir/ValueSet/tooth)
                                                    TypeCodeableReference(BodyStructure)
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Allows insurer to validate specific procedures.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    838. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.bodySite.subSite
                                                    Definition

                                                    A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                                    ShortSub-location
                                                    Control0..*
                                                    BindingFor example codes, see SurfaceCodes
                                                    (example to http://hl7.org/fhir/ValueSet/surface)
                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Allows insurer to validate specific procedures.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    840. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.encounter
                                                    Definition

                                                    Healthcare encounters related to this claim.

                                                    ShortEncounters associated with the listed treatments
                                                    Comments

                                                    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.

                                                    Control0..*
                                                    TypeReference(Encounter)
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Used in some jurisdictions to link clinical events to claim items.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    842. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail
                                                    Definition

                                                    A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                    ShortProduct or service provided
                                                    Control0..*
                                                    TypeBackboneElement
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    The items to be processed for adjudication.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    844. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    Typestring
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    846. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.extension
                                                    Definition

                                                    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.

                                                    ShortAdditional content defined by implementations
                                                    Comments

                                                    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.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    848. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.modifierExtension
                                                    Definition

                                                    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).

                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                    Comments

                                                    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.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                    Summarytrue
                                                    Requirements

                                                    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.

                                                    Alternate Namesextensions, user content, modifiers
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    850. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.sequence
                                                    Definition

                                                    A number to uniquely identify item entries.

                                                    ShortItem instance identifier
                                                    Control1..1
                                                    TypepositiveInt
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    852. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.traceNumber
                                                    Definition

                                                    Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                    ShortNumber for tracking
                                                    Control0..*
                                                    TypeIdentifier
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Allows partners to uniquely identify components for tracking.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    854. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.revenue
                                                    Definition

                                                    The type of revenue or cost center providing the product and/or service.

                                                    ShortRevenue or cost center code
                                                    Control0..1
                                                    BindingFor example codes, see ExampleRevenueCenterCodes
                                                    (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                    Codes for the revenue or cost centers supplying the service and/or products.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Needed in the processing of institutional claims.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    856. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.category
                                                    Definition

                                                    Code to identify the general type of benefits under which products and services are provided.

                                                    ShortBenefit classification
                                                    Comments

                                                    Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                    Control0..1
                                                    BindingFor example codes, see BenefitCategoryCodes
                                                    (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                    Benefit categories such as: oral-basic, major, glasses.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    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.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    858. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.productOrService
                                                    Definition

                                                    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.

                                                    ShortBilling, service, product, or drug code
                                                    Comments

                                                    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'.

                                                    Control0..1
                                                    BindingFor example codes, see USCLSCodes
                                                    (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                    Allowable service and product codes.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Necessary to state what was provided or done.

                                                    Alternate NamesDrug Code, Bill Code, Service Code
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    860. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.productOrServiceEnd
                                                    Definition

                                                    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.

                                                    ShortEnd of a range of codes
                                                    Control0..1
                                                    BindingFor example codes, see USCLSCodes
                                                    (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    862. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.modifier
                                                    Definition

                                                    Item typification or modifiers codes to convey additional context for the product or service.

                                                    ShortService/Product billing modifiers
                                                    Comments

                                                    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.

                                                    Control0..*
                                                    BindingFor example codes, see ModifierTypeCodes
                                                    (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                    Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    To support inclusion of the item for adjudication or to charge an elevated fee.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    864. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.programCode
                                                    Definition

                                                    Identifies the program under which this may be recovered.

                                                    ShortProgram the product or service is provided under
                                                    Comments

                                                    For example: Neonatal program, child dental program or drug users recovery program.

                                                    Control0..*
                                                    BindingFor example codes, see ExampleProgramReasonCodes
                                                    (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                    Program specific reason codes.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    866. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.patientPaid
                                                    Definition

                                                    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.

                                                    ShortPaid by the patient
                                                    Control0..1
                                                    TypeMoney
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    868. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.quantity
                                                    Definition

                                                    The number of repetitions of a service or product.

                                                    ShortCount of products or services
                                                    Control0..1
                                                    TypeQuantity(SimpleQuantity)
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Required when the product or service code does not convey the quantity provided.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    870. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.unitPrice
                                                    Definition

                                                    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.

                                                    ShortFee, charge or cost per item
                                                    Control0..1
                                                    TypeMoney
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    The amount charged to the patient by the provider for a single unit.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    872. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.factor
                                                    Definition

                                                    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.

                                                    ShortPrice scaling factor
                                                    Comments

                                                    To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                    Control0..1
                                                    Typedecimal
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    874. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.tax
                                                    Definition

                                                    The total of taxes applicable for this product or service.

                                                    ShortTotal tax
                                                    Control0..1
                                                    TypeMoney
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Required when taxes are not embedded in the unit price or provided as a separate service.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    876. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.net
                                                    Definition

                                                    The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                                    ShortTotal item cost
                                                    Comments

                                                    For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                    Control0..1
                                                    TypeMoney
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Provides the total amount claimed for the group (if a grouper) or the line item.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    878. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.udi
                                                    Definition

                                                    Unique Device Identifiers associated with this line item.

                                                    ShortUnique device identifier
                                                    Control0..*
                                                    TypeReference(Device)
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    The UDI code allows the insurer to obtain device level information on the product supplied.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    880. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail
                                                    Definition

                                                    A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                    ShortProduct or service provided
                                                    Control0..*
                                                    TypeBackboneElement
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    The items to be processed for adjudication.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    882. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    Typestring
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    884. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.extension
                                                    Definition

                                                    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.

                                                    ShortAdditional content defined by implementations
                                                    Comments

                                                    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.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    886. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.modifierExtension
                                                    Definition

                                                    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).

                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                    Comments

                                                    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.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                    Summarytrue
                                                    Requirements

                                                    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.

                                                    Alternate Namesextensions, user content, modifiers
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    888. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.sequence
                                                    Definition

                                                    A number to uniquely identify item entries.

                                                    ShortItem instance identifier
                                                    Control1..1
                                                    TypepositiveInt
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    890. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.traceNumber
                                                    Definition

                                                    Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                    ShortNumber for tracking
                                                    Control0..*
                                                    TypeIdentifier
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Allows partners to uniquely identify components for tracking.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    892. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.revenue
                                                    Definition

                                                    The type of revenue or cost center providing the product and/or service.

                                                    ShortRevenue or cost center code
                                                    Control0..1
                                                    BindingFor example codes, see ExampleRevenueCenterCodes
                                                    (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                    Codes for the revenue or cost centers supplying the service and/or products.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Needed in the processing of institutional claims.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    894. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.category
                                                    Definition

                                                    Code to identify the general type of benefits under which products and services are provided.

                                                    ShortBenefit classification
                                                    Comments

                                                    Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                    Control0..1
                                                    BindingFor example codes, see BenefitCategoryCodes
                                                    (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                    Benefit categories such as: oral-basic, major, glasses.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    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.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    896. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.productOrService
                                                    Definition

                                                    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.

                                                    ShortBilling, service, product, or drug code
                                                    Comments

                                                    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'.

                                                    Control0..1
                                                    BindingFor example codes, see USCLSCodes
                                                    (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                    Allowable service and product codes.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Necessary to state what was provided or done.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    898. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.productOrServiceEnd
                                                    Definition

                                                    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.

                                                    ShortEnd of a range of codes
                                                    Control0..1
                                                    BindingFor example codes, see USCLSCodes
                                                    (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    900. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.modifier
                                                    Definition

                                                    Item typification or modifiers codes to convey additional context for the product or service.

                                                    ShortService/Product billing modifiers
                                                    Comments

                                                    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.

                                                    Control0..*
                                                    BindingFor example codes, see ModifierTypeCodes
                                                    (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                    Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    To support inclusion of the item for adjudication or to charge an elevated fee.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    902. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.programCode
                                                    Definition

                                                    Identifies the program under which this may be recovered.

                                                    ShortProgram the product or service is provided under
                                                    Comments

                                                    For example: Neonatal program, child dental program or drug users recovery program.

                                                    Control0..*
                                                    BindingFor example codes, see ExampleProgramReasonCodes
                                                    (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                    Program specific reason codes.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    904. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.patientPaid
                                                    Definition

                                                    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.

                                                    ShortPaid by the patient
                                                    Control0..1
                                                    TypeMoney
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    906. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.quantity
                                                    Definition

                                                    The number of repetitions of a service or product.

                                                    ShortCount of products or services
                                                    Control0..1
                                                    TypeQuantity(SimpleQuantity)
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Required when the product or service code does not convey the quantity provided.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    908. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.unitPrice
                                                    Definition

                                                    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.

                                                    ShortFee, charge or cost per item
                                                    Control0..1
                                                    TypeMoney
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    The amount charged to the patient by the provider for a single unit.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    910. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.factor
                                                    Definition

                                                    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.

                                                    ShortPrice scaling factor
                                                    Comments

                                                    To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                    Control0..1
                                                    Typedecimal
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    912. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.tax
                                                    Definition

                                                    The total of taxes applicable for this product or service.

                                                    ShortTotal tax
                                                    Control0..1
                                                    TypeMoney
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Required when taxes are not embedded in the unit price or provided as a separate service.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    914. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.net
                                                    Definition

                                                    The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                                    ShortTotal item cost
                                                    Comments

                                                    For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                    Control0..1
                                                    TypeMoney
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Provides the total amount claimed for the group (if a grouper) or the line item.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    916. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.udi
                                                    Definition

                                                    Unique Device Identifiers associated with this line item.

                                                    ShortUnique device identifier
                                                    Control0..*
                                                    TypeReference(Device)
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    The UDI code allows the insurer to obtain device level information on the product supplied.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    918. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente
                                                    Slice NamePunkteBelagsdauerausreisserUntenTageskomponente
                                                    Definition

                                                    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.

                                                    ShortProduct or service provided
                                                    Control0..1
                                                    TypeBackboneElement
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    The items to be processed for adjudication.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    920. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    Typestring
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    922. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.extension
                                                    Definition

                                                    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.

                                                    ShortAdditional content defined by implementations
                                                    Comments

                                                    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.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    924. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.modifierExtension
                                                    Definition

                                                    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).

                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                    Comments

                                                    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.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                    Summarytrue
                                                    Requirements

                                                    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.

                                                    Alternate Namesextensions, user content, modifiers
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    926. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.sequence
                                                    Definition

                                                    A number to uniquely identify item entries.

                                                    ShortItem instance identifier
                                                    Control1..1
                                                    TypepositiveInt
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    928. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.traceNumber
                                                    Definition

                                                    Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                    ShortNumber for tracking
                                                    Control0..*
                                                    TypeIdentifier
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Allows partners to uniquely identify components for tracking.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    930. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.careTeamSequence
                                                    Definition

                                                    CareTeam members related to this service or product.

                                                    ShortApplicable careTeam members
                                                    Control0..*
                                                    TypepositiveInt
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Need to identify the individuals and their roles in the provision of the product or service.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    932. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.diagnosisSequence
                                                    Definition

                                                    Diagnosis applicable for this service or product.

                                                    ShortApplicable diagnoses
                                                    Control0..*
                                                    TypepositiveInt
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Need to related the product or service to the associated diagnoses.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    934. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.procedureSequence
                                                    Definition

                                                    Procedures applicable for this service or product.

                                                    ShortApplicable procedures
                                                    Control0..*
                                                    TypepositiveInt
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Need to provide any listed specific procedures to support the product or service being claimed.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    936. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.informationSequence
                                                    Definition

                                                    Exceptions, special conditions and supporting information applicable for this service or product.

                                                    ShortApplicable exception and supporting information
                                                    Control0..*
                                                    TypepositiveInt
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Need to reference the supporting information items that relate directly to this product or service.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    938. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.revenue
                                                    Definition

                                                    The type of revenue or cost center providing the product and/or service.

                                                    ShortRevenue or cost center code
                                                    Control0..1
                                                    BindingFor example codes, see ExampleRevenueCenterCodes
                                                    (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                    Codes for the revenue or cost centers supplying the service and/or products.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Needed in the processing of institutional claims.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    940. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.category
                                                    Definition

                                                    Code to identify the general type of benefits under which products and services are provided.

                                                    ShortBenefit classification
                                                    Comments

                                                    Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                    Control0..1
                                                    BindingFor example codes, see BenefitCategoryCodes
                                                    (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                    Benefit categories such as: oral-basic, major, glasses.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    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.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    942. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.category.id
                                                    Definition

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    Typeid
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    944. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.category.extension
                                                    Definition

                                                    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.

                                                    ShortAdditional content defined by implementations
                                                    Comments

                                                    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.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 946. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.category.coding
                                                      Definition

                                                      A reference to a code defined by a terminology system.

                                                      ShortCode defined by a terminology system
                                                      Comments

                                                      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.

                                                      Control1..*
                                                      BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                                      (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                                      TypeCoding
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Requirements

                                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                                      Pattern Value{
                                                        "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                                        "code" : "SCUTK"
                                                      }
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      948. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.category.text
                                                      Definition

                                                      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.

                                                      ShortPlain text representation of the concept
                                                      Comments

                                                      Very often the text is the same as a displayName of one of the codings.

                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      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.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      950. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.productOrService
                                                      Definition

                                                      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.

                                                      ShortBilling, service, product, or drug code
                                                      Comments

                                                      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'.

                                                      Control0..1
                                                      BindingFor example codes, see USCLSCodes
                                                      (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                      Allowable service and product codes.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Necessary to state what was provided or done.

                                                      Alternate NamesDrug Code, Bill Code, Service Code
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      952. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.productOrServiceEnd
                                                      Definition

                                                      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.

                                                      ShortEnd of a range of codes
                                                      Control0..1
                                                      BindingFor example codes, see USCLSCodes
                                                      (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      954. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.request
                                                      Definition

                                                      Request or Referral for Goods or Service to be rendered.

                                                      ShortRequest or Referral for Service
                                                      Control0..*
                                                      TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      May identify the service to be provided or provider authorization for the service.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      956. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.modifier
                                                      Definition

                                                      Item typification or modifiers codes to convey additional context for the product or service.

                                                      ShortProduct or service billing modifiers
                                                      Comments

                                                      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.

                                                      Control0..*
                                                      BindingFor example codes, see ModifierTypeCodes
                                                      (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                      Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      To support inclusion of the item for adjudication or to charge an elevated fee.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      958. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.programCode
                                                      Definition

                                                      Identifies the program under which this may be recovered.

                                                      ShortProgram the product or service is provided under
                                                      Comments

                                                      For example: Neonatal program, child dental program or drug users recovery program.

                                                      Control0..*
                                                      BindingFor example codes, see ExampleProgramReasonCodes
                                                      (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                      Program specific reason codes.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      960. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.serviced[x]
                                                      Definition

                                                      The date or dates when the service or product was supplied, performed or completed.

                                                      ShortDate or dates of service or product delivery
                                                      Control0..1
                                                      TypeChoice of: date, Period
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      962. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.location[x]
                                                      Definition

                                                      Where the product or service was provided.

                                                      ShortPlace of service or where product was supplied
                                                      Control0..1
                                                      BindingFor example codes, see ExampleServicePlaceCodes
                                                      (example to http://hl7.org/fhir/ValueSet/service-place)

                                                      Place of service: pharmacy, school, prison, etc.

                                                      TypeChoice of: CodeableConcept, Address, Reference(Location)
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      964. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.patientPaid
                                                      Definition

                                                      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.

                                                      ShortPaid by the patient
                                                      Control0..1
                                                      TypeMoney
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      966. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity
                                                      Definition

                                                      The number of repetitions of a service or product.

                                                      ShortPunkteanzahl
                                                      Control1..1
                                                      TypeQuantity(SimpleQuantity)
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Required when the product or service code does not convey the quantity provided.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      968. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.id
                                                      Definition

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

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typeid
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      970. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.extension
                                                      Definition

                                                      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.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      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.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 972. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.value
                                                        Definition

                                                        The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                        ShortNumerical value (with implicit precision)
                                                        Comments

                                                        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).

                                                        Control1..1
                                                        Typedecimal
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        Precision is handled implicitly in almost all cases of measurement.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        974. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.comparator
                                                        Definition

                                                        Not allowed to be used in this context

                                                        Short< | <= | >= | > | ad - how to understand the value
                                                        Control0..0
                                                        BindingThe codes SHALL be taken from QuantityComparator
                                                        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                                        How the Quantity should be understood and represented.

                                                        Typecode
                                                        Is Modifiertrue because 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
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                        Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        976. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.unit
                                                        Definition

                                                        A human-readable form of the unit.

                                                        ShortUnit representation
                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                        Pattern ValueLKF Punkte
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        978. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.system
                                                        Definition

                                                        The identification of the system that provides the coded form of the unit.

                                                        ShortSystem that defines coded unit form
                                                        Control0..1
                                                        This element is affected by the following invariants: qty-3
                                                        Typeuri
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        Need to know the system that defines the coded form of the unit.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        980. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.code
                                                        Definition

                                                        A computer processable form of the unit in some unit representation system.

                                                        ShortCoded form of the unit
                                                        Comments

                                                        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.

                                                        Control0..1
                                                        This element is affected by the following invariants: qty-3
                                                        Typecode
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        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.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        982. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.unitPrice
                                                        Definition

                                                        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.

                                                        ShortFee, charge or cost per item
                                                        Control0..1
                                                        TypeMoney
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        The amount charged to the patient by the provider for a single unit.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        984. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.factor
                                                        Definition

                                                        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.

                                                        ShortPrice scaling factor
                                                        Comments

                                                        To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                        Control0..1
                                                        Typedecimal
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        986. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.tax
                                                        Definition

                                                        The total of taxes applicable for this product or service.

                                                        ShortTotal tax
                                                        Control0..1
                                                        TypeMoney
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Required when taxes are not embedded in the unit price or provided as a separate service.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        988. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.net
                                                        Definition

                                                        The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                                        ShortTotal item cost
                                                        Comments

                                                        For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                        Control0..1
                                                        TypeMoney
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Provides the total amount claimed for the group (if a grouper) or the line item.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        990. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.udi
                                                        Definition

                                                        Unique Device Identifiers associated with this line item.

                                                        ShortUnique device identifier
                                                        Control0..*
                                                        TypeReference(Device)
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        The UDI code allows the insurer to obtain device level information on the product supplied.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        992. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.bodySite
                                                        Definition

                                                        Physical location where the service is performed or applies.

                                                        ShortAnatomical location
                                                        Control0..*
                                                        TypeBackboneElement
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        994. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.bodySite.id
                                                        Definition

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

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        996. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.bodySite.extension
                                                        Definition

                                                        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.

                                                        ShortAdditional content defined by implementations
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        998. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.bodySite.modifierExtension
                                                        Definition

                                                        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).

                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                        Summarytrue
                                                        Requirements

                                                        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.

                                                        Alternate Namesextensions, user content, modifiers
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        1000. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.bodySite.site
                                                        Definition

                                                        Physical service site on the patient (limb, tooth, etc.).

                                                        ShortLocation
                                                        Comments

                                                        For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                                        Control1..*
                                                        BindingFor example codes, see OralSiteCodes
                                                        (example to http://hl7.org/fhir/ValueSet/tooth)
                                                        TypeCodeableReference(BodyStructure)
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Allows insurer to validate specific procedures.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1002. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.bodySite.subSite
                                                        Definition

                                                        A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                                        ShortSub-location
                                                        Control0..*
                                                        BindingFor example codes, see SurfaceCodes
                                                        (example to http://hl7.org/fhir/ValueSet/surface)
                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Allows insurer to validate specific procedures.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1004. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.encounter
                                                        Definition

                                                        Healthcare encounters related to this claim.

                                                        ShortEncounters associated with the listed treatments
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        TypeReference(Encounter)
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Used in some jurisdictions to link clinical events to claim items.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1006. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail
                                                        Definition

                                                        A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                        ShortProduct or service provided
                                                        Control0..*
                                                        TypeBackboneElement
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        The items to be processed for adjudication.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1008. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.id
                                                        Definition

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

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        1010. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.extension
                                                        Definition

                                                        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.

                                                        ShortAdditional content defined by implementations
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        1012. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.modifierExtension
                                                        Definition

                                                        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).

                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                        Summarytrue
                                                        Requirements

                                                        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.

                                                        Alternate Namesextensions, user content, modifiers
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        1014. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.sequence
                                                        Definition

                                                        A number to uniquely identify item entries.

                                                        ShortItem instance identifier
                                                        Control1..1
                                                        TypepositiveInt
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1016. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.traceNumber
                                                        Definition

                                                        Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                        ShortNumber for tracking
                                                        Control0..*
                                                        TypeIdentifier
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Allows partners to uniquely identify components for tracking.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1018. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.revenue
                                                        Definition

                                                        The type of revenue or cost center providing the product and/or service.

                                                        ShortRevenue or cost center code
                                                        Control0..1
                                                        BindingFor example codes, see ExampleRevenueCenterCodes
                                                        (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                        Codes for the revenue or cost centers supplying the service and/or products.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Needed in the processing of institutional claims.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1020. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.category
                                                        Definition

                                                        Code to identify the general type of benefits under which products and services are provided.

                                                        ShortBenefit classification
                                                        Comments

                                                        Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                        Control0..1
                                                        BindingFor example codes, see BenefitCategoryCodes
                                                        (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                        Benefit categories such as: oral-basic, major, glasses.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        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.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1022. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.productOrService
                                                        Definition

                                                        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.

                                                        ShortBilling, service, product, or drug code
                                                        Comments

                                                        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'.

                                                        Control0..1
                                                        BindingFor example codes, see USCLSCodes
                                                        (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                        Allowable service and product codes.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Necessary to state what was provided or done.

                                                        Alternate NamesDrug Code, Bill Code, Service Code
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1024. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.productOrServiceEnd
                                                        Definition

                                                        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.

                                                        ShortEnd of a range of codes
                                                        Control0..1
                                                        BindingFor example codes, see USCLSCodes
                                                        (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1026. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.modifier
                                                        Definition

                                                        Item typification or modifiers codes to convey additional context for the product or service.

                                                        ShortService/Product billing modifiers
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        BindingFor example codes, see ModifierTypeCodes
                                                        (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                        Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        To support inclusion of the item for adjudication or to charge an elevated fee.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1028. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.programCode
                                                        Definition

                                                        Identifies the program under which this may be recovered.

                                                        ShortProgram the product or service is provided under
                                                        Comments

                                                        For example: Neonatal program, child dental program or drug users recovery program.

                                                        Control0..*
                                                        BindingFor example codes, see ExampleProgramReasonCodes
                                                        (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                        Program specific reason codes.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1030. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.patientPaid
                                                        Definition

                                                        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.

                                                        ShortPaid by the patient
                                                        Control0..1
                                                        TypeMoney
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1032. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.quantity
                                                        Definition

                                                        The number of repetitions of a service or product.

                                                        ShortCount of products or services
                                                        Control0..1
                                                        TypeQuantity(SimpleQuantity)
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Required when the product or service code does not convey the quantity provided.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1034. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.unitPrice
                                                        Definition

                                                        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.

                                                        ShortFee, charge or cost per item
                                                        Control0..1
                                                        TypeMoney
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        The amount charged to the patient by the provider for a single unit.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1036. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.factor
                                                        Definition

                                                        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.

                                                        ShortPrice scaling factor
                                                        Comments

                                                        To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                        Control0..1
                                                        Typedecimal
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1038. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.tax
                                                        Definition

                                                        The total of taxes applicable for this product or service.

                                                        ShortTotal tax
                                                        Control0..1
                                                        TypeMoney
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Required when taxes are not embedded in the unit price or provided as a separate service.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1040. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.net
                                                        Definition

                                                        The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                                        ShortTotal item cost
                                                        Comments

                                                        For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                        Control0..1
                                                        TypeMoney
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Provides the total amount claimed for the group (if a grouper) or the line item.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1042. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.udi
                                                        Definition

                                                        Unique Device Identifiers associated with this line item.

                                                        ShortUnique device identifier
                                                        Control0..*
                                                        TypeReference(Device)
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        The UDI code allows the insurer to obtain device level information on the product supplied.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1044. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail
                                                        Definition

                                                        A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                        ShortProduct or service provided
                                                        Control0..*
                                                        TypeBackboneElement
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        The items to be processed for adjudication.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1046. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.id
                                                        Definition

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

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        1048. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.extension
                                                        Definition

                                                        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.

                                                        ShortAdditional content defined by implementations
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        1050. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.modifierExtension
                                                        Definition

                                                        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).

                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                        Summarytrue
                                                        Requirements

                                                        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.

                                                        Alternate Namesextensions, user content, modifiers
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        1052. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.sequence
                                                        Definition

                                                        A number to uniquely identify item entries.

                                                        ShortItem instance identifier
                                                        Control1..1
                                                        TypepositiveInt
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1054. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.traceNumber
                                                        Definition

                                                        Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                        ShortNumber for tracking
                                                        Control0..*
                                                        TypeIdentifier
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Allows partners to uniquely identify components for tracking.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1056. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.revenue
                                                        Definition

                                                        The type of revenue or cost center providing the product and/or service.

                                                        ShortRevenue or cost center code
                                                        Control0..1
                                                        BindingFor example codes, see ExampleRevenueCenterCodes
                                                        (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                        Codes for the revenue or cost centers supplying the service and/or products.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Needed in the processing of institutional claims.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1058. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.category
                                                        Definition

                                                        Code to identify the general type of benefits under which products and services are provided.

                                                        ShortBenefit classification
                                                        Comments

                                                        Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                        Control0..1
                                                        BindingFor example codes, see BenefitCategoryCodes
                                                        (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                        Benefit categories such as: oral-basic, major, glasses.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        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.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1060. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.productOrService
                                                        Definition

                                                        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.

                                                        ShortBilling, service, product, or drug code
                                                        Comments

                                                        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'.

                                                        Control0..1
                                                        BindingFor example codes, see USCLSCodes
                                                        (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                        Allowable service and product codes.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Necessary to state what was provided or done.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1062. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.productOrServiceEnd
                                                        Definition

                                                        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.

                                                        ShortEnd of a range of codes
                                                        Control0..1
                                                        BindingFor example codes, see USCLSCodes
                                                        (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1064. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.modifier
                                                        Definition

                                                        Item typification or modifiers codes to convey additional context for the product or service.

                                                        ShortService/Product billing modifiers
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        BindingFor example codes, see ModifierTypeCodes
                                                        (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                        Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        To support inclusion of the item for adjudication or to charge an elevated fee.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1066. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.programCode
                                                        Definition

                                                        Identifies the program under which this may be recovered.

                                                        ShortProgram the product or service is provided under
                                                        Comments

                                                        For example: Neonatal program, child dental program or drug users recovery program.

                                                        Control0..*
                                                        BindingFor example codes, see ExampleProgramReasonCodes
                                                        (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                        Program specific reason codes.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1068. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.patientPaid
                                                        Definition

                                                        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.

                                                        ShortPaid by the patient
                                                        Control0..1
                                                        TypeMoney
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1070. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.quantity
                                                        Definition

                                                        The number of repetitions of a service or product.

                                                        ShortCount of products or services
                                                        Control0..1
                                                        TypeQuantity(SimpleQuantity)
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Required when the product or service code does not convey the quantity provided.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1072. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.unitPrice
                                                        Definition

                                                        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.

                                                        ShortFee, charge or cost per item
                                                        Control0..1
                                                        TypeMoney
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        The amount charged to the patient by the provider for a single unit.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1074. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.factor
                                                        Definition

                                                        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.

                                                        ShortPrice scaling factor
                                                        Comments

                                                        To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                        Control0..1
                                                        Typedecimal
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1076. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.tax
                                                        Definition

                                                        The total of taxes applicable for this product or service.

                                                        ShortTotal tax
                                                        Control0..1
                                                        TypeMoney
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Required when taxes are not embedded in the unit price or provided as a separate service.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1078. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.net
                                                        Definition

                                                        The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                                        ShortTotal item cost
                                                        Comments

                                                        For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                        Control0..1
                                                        TypeMoney
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Provides the total amount claimed for the group (if a grouper) or the line item.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1080. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.udi
                                                        Definition

                                                        Unique Device Identifiers associated with this line item.

                                                        ShortUnique device identifier
                                                        Control0..*
                                                        TypeReference(Device)
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        The UDI code allows the insurer to obtain device level information on the product supplied.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1082. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben
                                                        Slice NameZusatzpunkteBelagsdauerausreisserNachOben
                                                        Definition

                                                        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.

                                                        ShortProduct or service provided
                                                        Control0..1
                                                        TypeBackboneElement
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        The items to be processed for adjudication.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1084. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.id
                                                        Definition

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

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        Typestring
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        1086. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.extension
                                                        Definition

                                                        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.

                                                        ShortAdditional content defined by implementations
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        1088. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.modifierExtension
                                                        Definition

                                                        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).

                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                        Summarytrue
                                                        Requirements

                                                        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.

                                                        Alternate Namesextensions, user content, modifiers
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        1090. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.sequence
                                                        Definition

                                                        A number to uniquely identify item entries.

                                                        ShortItem instance identifier
                                                        Control1..1
                                                        TypepositiveInt
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1092. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.traceNumber
                                                        Definition

                                                        Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                        ShortNumber for tracking
                                                        Control0..*
                                                        TypeIdentifier
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Allows partners to uniquely identify components for tracking.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1094. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.careTeamSequence
                                                        Definition

                                                        CareTeam members related to this service or product.

                                                        ShortApplicable careTeam members
                                                        Control0..*
                                                        TypepositiveInt
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Need to identify the individuals and their roles in the provision of the product or service.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1096. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.diagnosisSequence
                                                        Definition

                                                        Diagnosis applicable for this service or product.

                                                        ShortApplicable diagnoses
                                                        Control0..*
                                                        TypepositiveInt
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Need to related the product or service to the associated diagnoses.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1098. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.procedureSequence
                                                        Definition

                                                        Procedures applicable for this service or product.

                                                        ShortApplicable procedures
                                                        Control0..*
                                                        TypepositiveInt
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Need to provide any listed specific procedures to support the product or service being claimed.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1100. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.informationSequence
                                                        Definition

                                                        Exceptions, special conditions and supporting information applicable for this service or product.

                                                        ShortApplicable exception and supporting information
                                                        Control0..*
                                                        TypepositiveInt
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Need to reference the supporting information items that relate directly to this product or service.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1102. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.revenue
                                                        Definition

                                                        The type of revenue or cost center providing the product and/or service.

                                                        ShortRevenue or cost center code
                                                        Control0..1
                                                        BindingFor example codes, see ExampleRevenueCenterCodes
                                                        (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                        Codes for the revenue or cost centers supplying the service and/or products.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Needed in the processing of institutional claims.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1104. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.category
                                                        Definition

                                                        Code to identify the general type of benefits under which products and services are provided.

                                                        ShortBenefit classification
                                                        Comments

                                                        Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                        Control0..1
                                                        BindingFor example codes, see BenefitCategoryCodes
                                                        (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                        Benefit categories such as: oral-basic, major, glasses.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        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.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1106. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.category.id
                                                        Definition

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

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        Typeid
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        1108. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.category.extension
                                                        Definition

                                                        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.

                                                        ShortAdditional content defined by implementations
                                                        Comments

                                                        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.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 1110. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.category.coding
                                                          Definition

                                                          A reference to a code defined by a terminology system.

                                                          ShortCode defined by a terminology system
                                                          Comments

                                                          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.

                                                          Control1..*
                                                          BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                                          (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                                          TypeCoding
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Requirements

                                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                                          Pattern Value{
                                                            "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                                            "code" : "BDZU"
                                                          }
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1112. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.category.text
                                                          Definition

                                                          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.

                                                          ShortPlain text representation of the concept
                                                          Comments

                                                          Very often the text is the same as a displayName of one of the codings.

                                                          Control0..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Requirements

                                                          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.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1114. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.productOrService
                                                          Definition

                                                          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.

                                                          ShortBilling, service, product, or drug code
                                                          Comments

                                                          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'.

                                                          Control0..1
                                                          BindingFor example codes, see USCLSCodes
                                                          (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                          Allowable service and product codes.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Necessary to state what was provided or done.

                                                          Alternate NamesDrug Code, Bill Code, Service Code
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1116. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.productOrServiceEnd
                                                          Definition

                                                          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.

                                                          ShortEnd of a range of codes
                                                          Control0..1
                                                          BindingFor example codes, see USCLSCodes
                                                          (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1118. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.request
                                                          Definition

                                                          Request or Referral for Goods or Service to be rendered.

                                                          ShortRequest or Referral for Service
                                                          Control0..*
                                                          TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          May identify the service to be provided or provider authorization for the service.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1120. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.modifier
                                                          Definition

                                                          Item typification or modifiers codes to convey additional context for the product or service.

                                                          ShortProduct or service billing modifiers
                                                          Comments

                                                          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.

                                                          Control0..*
                                                          BindingFor example codes, see ModifierTypeCodes
                                                          (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                          Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          To support inclusion of the item for adjudication or to charge an elevated fee.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1122. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.programCode
                                                          Definition

                                                          Identifies the program under which this may be recovered.

                                                          ShortProgram the product or service is provided under
                                                          Comments

                                                          For example: Neonatal program, child dental program or drug users recovery program.

                                                          Control0..*
                                                          BindingFor example codes, see ExampleProgramReasonCodes
                                                          (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                          Program specific reason codes.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1124. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.serviced[x]
                                                          Definition

                                                          The date or dates when the service or product was supplied, performed or completed.

                                                          ShortDate or dates of service or product delivery
                                                          Control0..1
                                                          TypeChoice of: date, Period
                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1126. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.location[x]
                                                          Definition

                                                          Where the product or service was provided.

                                                          ShortPlace of service or where product was supplied
                                                          Control0..1
                                                          BindingFor example codes, see ExampleServicePlaceCodes
                                                          (example to http://hl7.org/fhir/ValueSet/service-place)

                                                          Place of service: pharmacy, school, prison, etc.

                                                          TypeChoice of: CodeableConcept, Address, Reference(Location)
                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1128. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.patientPaid
                                                          Definition

                                                          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.

                                                          ShortPaid by the patient
                                                          Control0..1
                                                          TypeMoney
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1130. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity
                                                          Definition

                                                          The number of repetitions of a service or product.

                                                          ShortPunkteanzahl
                                                          Control1..1
                                                          TypeQuantity(SimpleQuantity)
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Required when the product or service code does not convey the quantity provided.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1132. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.id
                                                          Definition

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

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          Typeid
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          1134. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.extension
                                                          Definition

                                                          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.

                                                          ShortAdditional content defined by implementations
                                                          Comments

                                                          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.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Alternate Namesextensions, user content
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 1136. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.value
                                                            Definition

                                                            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                            ShortNumerical value (with implicit precision)
                                                            Comments

                                                            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).

                                                            Control1..1
                                                            Typedecimal
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Requirements

                                                            Precision is handled implicitly in almost all cases of measurement.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1138. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.comparator
                                                            Definition

                                                            Not allowed to be used in this context

                                                            Short< | <= | >= | > | ad - how to understand the value
                                                            Control0..0
                                                            BindingThe codes SHALL be taken from QuantityComparator
                                                            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                                            How the Quantity should be understood and represented.

                                                            Typecode
                                                            Is Modifiertrue because 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
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Requirements

                                                            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                            Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1140. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.unit
                                                            Definition

                                                            A human-readable form of the unit.

                                                            ShortUnit representation
                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Requirements

                                                            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                            Pattern ValueLKF Punkte
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1142. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.system
                                                            Definition

                                                            The identification of the system that provides the coded form of the unit.

                                                            ShortSystem that defines coded unit form
                                                            Control0..1
                                                            This element is affected by the following invariants: qty-3
                                                            Typeuri
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Requirements

                                                            Need to know the system that defines the coded form of the unit.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1144. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.code
                                                            Definition

                                                            A computer processable form of the unit in some unit representation system.

                                                            ShortCoded form of the unit
                                                            Comments

                                                            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.

                                                            Control0..1
                                                            This element is affected by the following invariants: qty-3
                                                            Typecode
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Requirements

                                                            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.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1146. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.unitPrice
                                                            Definition

                                                            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.

                                                            ShortFee, charge or cost per item
                                                            Control0..1
                                                            TypeMoney
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            The amount charged to the patient by the provider for a single unit.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1148. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.factor
                                                            Definition

                                                            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.

                                                            ShortPrice scaling factor
                                                            Comments

                                                            To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                            Control0..1
                                                            Typedecimal
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1150. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.tax
                                                            Definition

                                                            The total of taxes applicable for this product or service.

                                                            ShortTotal tax
                                                            Control0..1
                                                            TypeMoney
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Required when taxes are not embedded in the unit price or provided as a separate service.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1152. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.net
                                                            Definition

                                                            The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                                            ShortTotal item cost
                                                            Comments

                                                            For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                            Control0..1
                                                            TypeMoney
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Provides the total amount claimed for the group (if a grouper) or the line item.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1154. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.udi
                                                            Definition

                                                            Unique Device Identifiers associated with this line item.

                                                            ShortUnique device identifier
                                                            Control0..*
                                                            TypeReference(Device)
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            The UDI code allows the insurer to obtain device level information on the product supplied.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1156. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.bodySite
                                                            Definition

                                                            Physical location where the service is performed or applies.

                                                            ShortAnatomical location
                                                            Control0..*
                                                            TypeBackboneElement
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1158. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.bodySite.id
                                                            Definition

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

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            Typestring
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            1160. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.bodySite.extension
                                                            Definition

                                                            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.

                                                            ShortAdditional content defined by implementations
                                                            Comments

                                                            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.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Alternate Namesextensions, user content
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            1162. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.bodySite.modifierExtension
                                                            Definition

                                                            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).

                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                            Comments

                                                            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.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                            Summarytrue
                                                            Requirements

                                                            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.

                                                            Alternate Namesextensions, user content, modifiers
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            1164. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.bodySite.site
                                                            Definition

                                                            Physical service site on the patient (limb, tooth, etc.).

                                                            ShortLocation
                                                            Comments

                                                            For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                                            Control1..*
                                                            BindingFor example codes, see OralSiteCodes
                                                            (example to http://hl7.org/fhir/ValueSet/tooth)
                                                            TypeCodeableReference(BodyStructure)
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Allows insurer to validate specific procedures.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1166. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.bodySite.subSite
                                                            Definition

                                                            A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                                            ShortSub-location
                                                            Control0..*
                                                            BindingFor example codes, see SurfaceCodes
                                                            (example to http://hl7.org/fhir/ValueSet/surface)
                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Allows insurer to validate specific procedures.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1168. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.encounter
                                                            Definition

                                                            Healthcare encounters related to this claim.

                                                            ShortEncounters associated with the listed treatments
                                                            Comments

                                                            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.

                                                            Control0..*
                                                            TypeReference(Encounter)
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Used in some jurisdictions to link clinical events to claim items.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1170. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail
                                                            Definition

                                                            A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                            ShortProduct or service provided
                                                            Control0..*
                                                            TypeBackboneElement
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            The items to be processed for adjudication.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1172. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.id
                                                            Definition

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

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            Typestring
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            1174. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.extension
                                                            Definition

                                                            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.

                                                            ShortAdditional content defined by implementations
                                                            Comments

                                                            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.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Alternate Namesextensions, user content
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            1176. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.modifierExtension
                                                            Definition

                                                            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).

                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                            Comments

                                                            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.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                            Summarytrue
                                                            Requirements

                                                            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.

                                                            Alternate Namesextensions, user content, modifiers
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            1178. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.sequence
                                                            Definition

                                                            A number to uniquely identify item entries.

                                                            ShortItem instance identifier
                                                            Control1..1
                                                            TypepositiveInt
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1180. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.traceNumber
                                                            Definition

                                                            Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                            ShortNumber for tracking
                                                            Control0..*
                                                            TypeIdentifier
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Allows partners to uniquely identify components for tracking.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1182. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.revenue
                                                            Definition

                                                            The type of revenue or cost center providing the product and/or service.

                                                            ShortRevenue or cost center code
                                                            Control0..1
                                                            BindingFor example codes, see ExampleRevenueCenterCodes
                                                            (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                            Codes for the revenue or cost centers supplying the service and/or products.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Needed in the processing of institutional claims.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1184. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.category
                                                            Definition

                                                            Code to identify the general type of benefits under which products and services are provided.

                                                            ShortBenefit classification
                                                            Comments

                                                            Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                            Control0..1
                                                            BindingFor example codes, see BenefitCategoryCodes
                                                            (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                            Benefit categories such as: oral-basic, major, glasses.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            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.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1186. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.productOrService
                                                            Definition

                                                            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.

                                                            ShortBilling, service, product, or drug code
                                                            Comments

                                                            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'.

                                                            Control0..1
                                                            BindingFor example codes, see USCLSCodes
                                                            (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                            Allowable service and product codes.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Necessary to state what was provided or done.

                                                            Alternate NamesDrug Code, Bill Code, Service Code
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1188. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.productOrServiceEnd
                                                            Definition

                                                            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.

                                                            ShortEnd of a range of codes
                                                            Control0..1
                                                            BindingFor example codes, see USCLSCodes
                                                            (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1190. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.modifier
                                                            Definition

                                                            Item typification or modifiers codes to convey additional context for the product or service.

                                                            ShortService/Product billing modifiers
                                                            Comments

                                                            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.

                                                            Control0..*
                                                            BindingFor example codes, see ModifierTypeCodes
                                                            (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                            Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            To support inclusion of the item for adjudication or to charge an elevated fee.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1192. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.programCode
                                                            Definition

                                                            Identifies the program under which this may be recovered.

                                                            ShortProgram the product or service is provided under
                                                            Comments

                                                            For example: Neonatal program, child dental program or drug users recovery program.

                                                            Control0..*
                                                            BindingFor example codes, see ExampleProgramReasonCodes
                                                            (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                            Program specific reason codes.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1194. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.patientPaid
                                                            Definition

                                                            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.

                                                            ShortPaid by the patient
                                                            Control0..1
                                                            TypeMoney
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1196. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.quantity
                                                            Definition

                                                            The number of repetitions of a service or product.

                                                            ShortCount of products or services
                                                            Control0..1
                                                            TypeQuantity(SimpleQuantity)
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Required when the product or service code does not convey the quantity provided.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1198. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.unitPrice
                                                            Definition

                                                            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.

                                                            ShortFee, charge or cost per item
                                                            Control0..1
                                                            TypeMoney
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            The amount charged to the patient by the provider for a single unit.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1200. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.factor
                                                            Definition

                                                            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.

                                                            ShortPrice scaling factor
                                                            Comments

                                                            To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                            Control0..1
                                                            Typedecimal
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1202. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.tax
                                                            Definition

                                                            The total of taxes applicable for this product or service.

                                                            ShortTotal tax
                                                            Control0..1
                                                            TypeMoney
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Required when taxes are not embedded in the unit price or provided as a separate service.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1204. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.net
                                                            Definition

                                                            The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                                            ShortTotal item cost
                                                            Comments

                                                            For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                            Control0..1
                                                            TypeMoney
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Provides the total amount claimed for the group (if a grouper) or the line item.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1206. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.udi
                                                            Definition

                                                            Unique Device Identifiers associated with this line item.

                                                            ShortUnique device identifier
                                                            Control0..*
                                                            TypeReference(Device)
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            The UDI code allows the insurer to obtain device level information on the product supplied.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1208. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail
                                                            Definition

                                                            A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                            ShortProduct or service provided
                                                            Control0..*
                                                            TypeBackboneElement
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            The items to be processed for adjudication.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1210. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.id
                                                            Definition

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

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            Typestring
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            1212. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.extension
                                                            Definition

                                                            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.

                                                            ShortAdditional content defined by implementations
                                                            Comments

                                                            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.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Alternate Namesextensions, user content
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            1214. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.modifierExtension
                                                            Definition

                                                            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).

                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                            Comments

                                                            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.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                            Summarytrue
                                                            Requirements

                                                            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.

                                                            Alternate Namesextensions, user content, modifiers
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            1216. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.sequence
                                                            Definition

                                                            A number to uniquely identify item entries.

                                                            ShortItem instance identifier
                                                            Control1..1
                                                            TypepositiveInt
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1218. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.traceNumber
                                                            Definition

                                                            Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                            ShortNumber for tracking
                                                            Control0..*
                                                            TypeIdentifier
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Allows partners to uniquely identify components for tracking.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1220. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.revenue
                                                            Definition

                                                            The type of revenue or cost center providing the product and/or service.

                                                            ShortRevenue or cost center code
                                                            Control0..1
                                                            BindingFor example codes, see ExampleRevenueCenterCodes
                                                            (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                            Codes for the revenue or cost centers supplying the service and/or products.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Needed in the processing of institutional claims.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1222. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.category
                                                            Definition

                                                            Code to identify the general type of benefits under which products and services are provided.

                                                            ShortBenefit classification
                                                            Comments

                                                            Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                            Control0..1
                                                            BindingFor example codes, see BenefitCategoryCodes
                                                            (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                            Benefit categories such as: oral-basic, major, glasses.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            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.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1224. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.productOrService
                                                            Definition

                                                            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.

                                                            ShortBilling, service, product, or drug code
                                                            Comments

                                                            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'.

                                                            Control0..1
                                                            BindingFor example codes, see USCLSCodes
                                                            (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                            Allowable service and product codes.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Necessary to state what was provided or done.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1226. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.productOrServiceEnd
                                                            Definition

                                                            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.

                                                            ShortEnd of a range of codes
                                                            Control0..1
                                                            BindingFor example codes, see USCLSCodes
                                                            (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1228. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.modifier
                                                            Definition

                                                            Item typification or modifiers codes to convey additional context for the product or service.

                                                            ShortService/Product billing modifiers
                                                            Comments

                                                            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.

                                                            Control0..*
                                                            BindingFor example codes, see ModifierTypeCodes
                                                            (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                            Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            To support inclusion of the item for adjudication or to charge an elevated fee.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1230. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.programCode
                                                            Definition

                                                            Identifies the program under which this may be recovered.

                                                            ShortProgram the product or service is provided under
                                                            Comments

                                                            For example: Neonatal program, child dental program or drug users recovery program.

                                                            Control0..*
                                                            BindingFor example codes, see ExampleProgramReasonCodes
                                                            (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                            Program specific reason codes.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1232. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.patientPaid
                                                            Definition

                                                            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.

                                                            ShortPaid by the patient
                                                            Control0..1
                                                            TypeMoney
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1234. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.quantity
                                                            Definition

                                                            The number of repetitions of a service or product.

                                                            ShortCount of products or services
                                                            Control0..1
                                                            TypeQuantity(SimpleQuantity)
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Required when the product or service code does not convey the quantity provided.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1236. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.unitPrice
                                                            Definition

                                                            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.

                                                            ShortFee, charge or cost per item
                                                            Control0..1
                                                            TypeMoney
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            The amount charged to the patient by the provider for a single unit.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1238. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.factor
                                                            Definition

                                                            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.

                                                            ShortPrice scaling factor
                                                            Comments

                                                            To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                            Control0..1
                                                            Typedecimal
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1240. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.tax
                                                            Definition

                                                            The total of taxes applicable for this product or service.

                                                            ShortTotal tax
                                                            Control0..1
                                                            TypeMoney
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Required when taxes are not embedded in the unit price or provided as a separate service.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1242. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.net
                                                            Definition

                                                            The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                                            ShortTotal item cost
                                                            Comments

                                                            For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                            Control0..1
                                                            TypeMoney
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Provides the total amount claimed for the group (if a grouper) or the line item.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1244. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.udi
                                                            Definition

                                                            Unique Device Identifiers associated with this line item.

                                                            ShortUnique device identifier
                                                            Control0..*
                                                            TypeReference(Device)
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            The UDI code allows the insurer to obtain device level information on the product supplied.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1246. Claim.item:ZusatzpunkteIntensiv
                                                            Slice NameZusatzpunkteIntensiv
                                                            Definition

                                                            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.

                                                            ShortProduct or service provided
                                                            Control0..1
                                                            TypeBackboneElement
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            The items to be processed for adjudication.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1248. Claim.item:ZusatzpunkteIntensiv.id
                                                            Definition

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

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            Typestring
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            1250. Claim.item:ZusatzpunkteIntensiv.extension
                                                            Definition

                                                            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.

                                                            ShortAdditional content defined by implementations
                                                            Comments

                                                            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.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Alternate Namesextensions, user content
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            1252. Claim.item:ZusatzpunkteIntensiv.modifierExtension
                                                            Definition

                                                            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).

                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                            Comments

                                                            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.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                            Summarytrue
                                                            Requirements

                                                            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.

                                                            Alternate Namesextensions, user content, modifiers
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            1254. Claim.item:ZusatzpunkteIntensiv.sequence
                                                            Definition

                                                            A number to uniquely identify item entries.

                                                            ShortItem instance identifier
                                                            Control1..1
                                                            TypepositiveInt
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1256. Claim.item:ZusatzpunkteIntensiv.traceNumber
                                                            Definition

                                                            Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                            ShortNumber for tracking
                                                            Control0..*
                                                            TypeIdentifier
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Allows partners to uniquely identify components for tracking.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1258. Claim.item:ZusatzpunkteIntensiv.careTeamSequence
                                                            Definition

                                                            CareTeam members related to this service or product.

                                                            ShortApplicable careTeam members
                                                            Control0..*
                                                            TypepositiveInt
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Need to identify the individuals and their roles in the provision of the product or service.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1260. Claim.item:ZusatzpunkteIntensiv.diagnosisSequence
                                                            Definition

                                                            Diagnosis applicable for this service or product.

                                                            ShortApplicable diagnoses
                                                            Control0..*
                                                            TypepositiveInt
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Need to related the product or service to the associated diagnoses.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1262. Claim.item:ZusatzpunkteIntensiv.procedureSequence
                                                            Definition

                                                            Procedures applicable for this service or product.

                                                            ShortApplicable procedures
                                                            Control0..*
                                                            TypepositiveInt
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Need to provide any listed specific procedures to support the product or service being claimed.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1264. Claim.item:ZusatzpunkteIntensiv.informationSequence
                                                            Definition

                                                            Exceptions, special conditions and supporting information applicable for this service or product.

                                                            ShortApplicable exception and supporting information
                                                            Control0..*
                                                            TypepositiveInt
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Need to reference the supporting information items that relate directly to this product or service.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1266. Claim.item:ZusatzpunkteIntensiv.revenue
                                                            Definition

                                                            The type of revenue or cost center providing the product and/or service.

                                                            ShortRevenue or cost center code
                                                            Control0..1
                                                            BindingFor example codes, see ExampleRevenueCenterCodes
                                                            (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                            Codes for the revenue or cost centers supplying the service and/or products.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Needed in the processing of institutional claims.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1268. Claim.item:ZusatzpunkteIntensiv.category
                                                            Definition

                                                            Code to identify the general type of benefits under which products and services are provided.

                                                            ShortBenefit classification
                                                            Comments

                                                            Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                            Control0..1
                                                            BindingFor example codes, see BenefitCategoryCodes
                                                            (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                            Benefit categories such as: oral-basic, major, glasses.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            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.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1270. Claim.item:ZusatzpunkteIntensiv.category.id
                                                            Definition

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

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            Typeid
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            1272. Claim.item:ZusatzpunkteIntensiv.category.extension
                                                            Definition

                                                            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.

                                                            ShortAdditional content defined by implementations
                                                            Comments

                                                            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.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Alternate Namesextensions, user content
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 1274. Claim.item:ZusatzpunkteIntensiv.category.coding
                                                              Definition

                                                              A reference to a code defined by a terminology system.

                                                              ShortCode defined by a terminology system
                                                              Comments

                                                              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.

                                                              Control1..*
                                                              BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                                              (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                                              TypeCoding
                                                              Is Modifierfalse
                                                              Summarytrue
                                                              Requirements

                                                              Allows for alternative encodings within a code system, and translations to other code systems.

                                                              Pattern Value{
                                                                "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                                                "code" : "INTZU"
                                                              }
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1276. Claim.item:ZusatzpunkteIntensiv.category.text
                                                              Definition

                                                              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.

                                                              ShortPlain text representation of the concept
                                                              Comments

                                                              Very often the text is the same as a displayName of one of the codings.

                                                              Control0..1
                                                              Typestring
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Requirements

                                                              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.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1278. Claim.item:ZusatzpunkteIntensiv.productOrService
                                                              Definition

                                                              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.

                                                              ShortBilling, service, product, or drug code
                                                              Comments

                                                              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'.

                                                              Control0..1
                                                              BindingFor example codes, see USCLSCodes
                                                              (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                              Allowable service and product codes.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Necessary to state what was provided or done.

                                                              Alternate NamesDrug Code, Bill Code, Service Code
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1280. Claim.item:ZusatzpunkteIntensiv.productOrServiceEnd
                                                              Definition

                                                              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.

                                                              ShortEnd of a range of codes
                                                              Control0..1
                                                              BindingFor example codes, see USCLSCodes
                                                              (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1282. Claim.item:ZusatzpunkteIntensiv.request
                                                              Definition

                                                              Request or Referral for Goods or Service to be rendered.

                                                              ShortRequest or Referral for Service
                                                              Control0..*
                                                              TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              May identify the service to be provided or provider authorization for the service.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1284. Claim.item:ZusatzpunkteIntensiv.modifier
                                                              Definition

                                                              Item typification or modifiers codes to convey additional context for the product or service.

                                                              ShortProduct or service billing modifiers
                                                              Comments

                                                              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.

                                                              Control0..*
                                                              BindingFor example codes, see ModifierTypeCodes
                                                              (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                              Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              To support inclusion of the item for adjudication or to charge an elevated fee.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1286. Claim.item:ZusatzpunkteIntensiv.programCode
                                                              Definition

                                                              Identifies the program under which this may be recovered.

                                                              ShortProgram the product or service is provided under
                                                              Comments

                                                              For example: Neonatal program, child dental program or drug users recovery program.

                                                              Control0..*
                                                              BindingFor example codes, see ExampleProgramReasonCodes
                                                              (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                              Program specific reason codes.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1288. Claim.item:ZusatzpunkteIntensiv.serviced[x]
                                                              Definition

                                                              The date or dates when the service or product was supplied, performed or completed.

                                                              ShortDate or dates of service or product delivery
                                                              Control0..1
                                                              TypeChoice of: date, Period
                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1290. Claim.item:ZusatzpunkteIntensiv.location[x]
                                                              Definition

                                                              Where the product or service was provided.

                                                              ShortPlace of service or where product was supplied
                                                              Control0..1
                                                              BindingFor example codes, see ExampleServicePlaceCodes
                                                              (example to http://hl7.org/fhir/ValueSet/service-place)

                                                              Place of service: pharmacy, school, prison, etc.

                                                              TypeChoice of: CodeableConcept, Address, Reference(Location)
                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1292. Claim.item:ZusatzpunkteIntensiv.patientPaid
                                                              Definition

                                                              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.

                                                              ShortPaid by the patient
                                                              Control0..1
                                                              TypeMoney
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1294. Claim.item:ZusatzpunkteIntensiv.quantity
                                                              Definition

                                                              The number of repetitions of a service or product.

                                                              ShortPunkteanzahl
                                                              Control1..1
                                                              TypeQuantity(SimpleQuantity)
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Required when the product or service code does not convey the quantity provided.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1296. Claim.item:ZusatzpunkteIntensiv.quantity.id
                                                              Definition

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

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              Typeid
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              1298. Claim.item:ZusatzpunkteIntensiv.quantity.extension
                                                              Definition

                                                              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.

                                                              ShortAdditional content defined by implementations
                                                              Comments

                                                              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.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Alternate Namesextensions, user content
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 1300. Claim.item:ZusatzpunkteIntensiv.quantity.value
                                                                Definition

                                                                The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                ShortNumerical value (with implicit precision)
                                                                Comments

                                                                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).

                                                                Control1..1
                                                                Typedecimal
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summarytrue
                                                                Requirements

                                                                Precision is handled implicitly in almost all cases of measurement.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1302. Claim.item:ZusatzpunkteIntensiv.quantity.comparator
                                                                Definition

                                                                Not allowed to be used in this context

                                                                Short< | <= | >= | > | ad - how to understand the value
                                                                Control0..0
                                                                BindingThe codes SHALL be taken from QuantityComparator
                                                                (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                                                How the Quantity should be understood and represented.

                                                                Typecode
                                                                Is Modifiertrue because 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
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summarytrue
                                                                Requirements

                                                                Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1304. Claim.item:ZusatzpunkteIntensiv.quantity.unit
                                                                Definition

                                                                A human-readable form of the unit.

                                                                ShortUnit representation
                                                                Control0..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summarytrue
                                                                Requirements

                                                                There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                Pattern ValueLKF Punkte
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1306. Claim.item:ZusatzpunkteIntensiv.quantity.system
                                                                Definition

                                                                The identification of the system that provides the coded form of the unit.

                                                                ShortSystem that defines coded unit form
                                                                Control0..1
                                                                This element is affected by the following invariants: qty-3
                                                                Typeuri
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summarytrue
                                                                Requirements

                                                                Need to know the system that defines the coded form of the unit.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1308. Claim.item:ZusatzpunkteIntensiv.quantity.code
                                                                Definition

                                                                A computer processable form of the unit in some unit representation system.

                                                                ShortCoded form of the unit
                                                                Comments

                                                                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.

                                                                Control0..1
                                                                This element is affected by the following invariants: qty-3
                                                                Typecode
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summarytrue
                                                                Requirements

                                                                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.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1310. Claim.item:ZusatzpunkteIntensiv.unitPrice
                                                                Definition

                                                                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.

                                                                ShortFee, charge or cost per item
                                                                Control0..1
                                                                TypeMoney
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                The amount charged to the patient by the provider for a single unit.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1312. Claim.item:ZusatzpunkteIntensiv.factor
                                                                Definition

                                                                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.

                                                                ShortPrice scaling factor
                                                                Comments

                                                                To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                Control0..1
                                                                Typedecimal
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1314. Claim.item:ZusatzpunkteIntensiv.tax
                                                                Definition

                                                                The total of taxes applicable for this product or service.

                                                                ShortTotal tax
                                                                Control0..1
                                                                TypeMoney
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Required when taxes are not embedded in the unit price or provided as a separate service.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1316. Claim.item:ZusatzpunkteIntensiv.net
                                                                Definition

                                                                The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                                                ShortTotal item cost
                                                                Comments

                                                                For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                Control0..1
                                                                TypeMoney
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1318. Claim.item:ZusatzpunkteIntensiv.udi
                                                                Definition

                                                                Unique Device Identifiers associated with this line item.

                                                                ShortUnique device identifier
                                                                Control0..*
                                                                TypeReference(Device)
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1320. Claim.item:ZusatzpunkteIntensiv.bodySite
                                                                Definition

                                                                Physical location where the service is performed or applies.

                                                                ShortAnatomical location
                                                                Control0..*
                                                                TypeBackboneElement
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1322. Claim.item:ZusatzpunkteIntensiv.bodySite.id
                                                                Definition

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

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                Typestring
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                1324. Claim.item:ZusatzpunkteIntensiv.bodySite.extension
                                                                Definition

                                                                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.

                                                                ShortAdditional content defined by implementations
                                                                Comments

                                                                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.

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Alternate Namesextensions, user content
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                1326. Claim.item:ZusatzpunkteIntensiv.bodySite.modifierExtension
                                                                Definition

                                                                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).

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

                                                                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.

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                Summarytrue
                                                                Requirements

                                                                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.

                                                                Alternate Namesextensions, user content, modifiers
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                1328. Claim.item:ZusatzpunkteIntensiv.bodySite.site
                                                                Definition

                                                                Physical service site on the patient (limb, tooth, etc.).

                                                                ShortLocation
                                                                Comments

                                                                For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                                                Control1..*
                                                                BindingFor example codes, see OralSiteCodes
                                                                (example to http://hl7.org/fhir/ValueSet/tooth)
                                                                TypeCodeableReference(BodyStructure)
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Allows insurer to validate specific procedures.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1330. Claim.item:ZusatzpunkteIntensiv.bodySite.subSite
                                                                Definition

                                                                A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                                                ShortSub-location
                                                                Control0..*
                                                                BindingFor example codes, see SurfaceCodes
                                                                (example to http://hl7.org/fhir/ValueSet/surface)
                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Allows insurer to validate specific procedures.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1332. Claim.item:ZusatzpunkteIntensiv.encounter
                                                                Definition

                                                                Healthcare encounters related to this claim.

                                                                ShortEncounters associated with the listed treatments
                                                                Comments

                                                                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.

                                                                Control0..*
                                                                TypeReference(Encounter)
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Used in some jurisdictions to link clinical events to claim items.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1334. Claim.item:ZusatzpunkteIntensiv.detail
                                                                Definition

                                                                A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                                ShortProduct or service provided
                                                                Control0..*
                                                                TypeBackboneElement
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                The items to be processed for adjudication.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1336. Claim.item:ZusatzpunkteIntensiv.detail.id
                                                                Definition

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

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                Typestring
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                1338. Claim.item:ZusatzpunkteIntensiv.detail.extension
                                                                Definition

                                                                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.

                                                                ShortAdditional content defined by implementations
                                                                Comments

                                                                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.

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Alternate Namesextensions, user content
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                1340. Claim.item:ZusatzpunkteIntensiv.detail.modifierExtension
                                                                Definition

                                                                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).

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

                                                                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.

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                Summarytrue
                                                                Requirements

                                                                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.

                                                                Alternate Namesextensions, user content, modifiers
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                1342. Claim.item:ZusatzpunkteIntensiv.detail.sequence
                                                                Definition

                                                                A number to uniquely identify item entries.

                                                                ShortItem instance identifier
                                                                Control1..1
                                                                TypepositiveInt
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1344. Claim.item:ZusatzpunkteIntensiv.detail.traceNumber
                                                                Definition

                                                                Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                                ShortNumber for tracking
                                                                Control0..*
                                                                TypeIdentifier
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Allows partners to uniquely identify components for tracking.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1346. Claim.item:ZusatzpunkteIntensiv.detail.revenue
                                                                Definition

                                                                The type of revenue or cost center providing the product and/or service.

                                                                ShortRevenue or cost center code
                                                                Control0..1
                                                                BindingFor example codes, see ExampleRevenueCenterCodes
                                                                (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                                Codes for the revenue or cost centers supplying the service and/or products.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Needed in the processing of institutional claims.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1348. Claim.item:ZusatzpunkteIntensiv.detail.category
                                                                Definition

                                                                Code to identify the general type of benefits under which products and services are provided.

                                                                ShortBenefit classification
                                                                Comments

                                                                Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                Control0..1
                                                                BindingFor example codes, see BenefitCategoryCodes
                                                                (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                                Benefit categories such as: oral-basic, major, glasses.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                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.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1350. Claim.item:ZusatzpunkteIntensiv.detail.productOrService
                                                                Definition

                                                                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.

                                                                ShortBilling, service, product, or drug code
                                                                Comments

                                                                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'.

                                                                Control0..1
                                                                BindingFor example codes, see USCLSCodes
                                                                (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                                Allowable service and product codes.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Necessary to state what was provided or done.

                                                                Alternate NamesDrug Code, Bill Code, Service Code
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1352. Claim.item:ZusatzpunkteIntensiv.detail.productOrServiceEnd
                                                                Definition

                                                                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.

                                                                ShortEnd of a range of codes
                                                                Control0..1
                                                                BindingFor example codes, see USCLSCodes
                                                                (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1354. Claim.item:ZusatzpunkteIntensiv.detail.modifier
                                                                Definition

                                                                Item typification or modifiers codes to convey additional context for the product or service.

                                                                ShortService/Product billing modifiers
                                                                Comments

                                                                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.

                                                                Control0..*
                                                                BindingFor example codes, see ModifierTypeCodes
                                                                (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                                Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1356. Claim.item:ZusatzpunkteIntensiv.detail.programCode
                                                                Definition

                                                                Identifies the program under which this may be recovered.

                                                                ShortProgram the product or service is provided under
                                                                Comments

                                                                For example: Neonatal program, child dental program or drug users recovery program.

                                                                Control0..*
                                                                BindingFor example codes, see ExampleProgramReasonCodes
                                                                (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                                Program specific reason codes.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1358. Claim.item:ZusatzpunkteIntensiv.detail.patientPaid
                                                                Definition

                                                                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.

                                                                ShortPaid by the patient
                                                                Control0..1
                                                                TypeMoney
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1360. Claim.item:ZusatzpunkteIntensiv.detail.quantity
                                                                Definition

                                                                The number of repetitions of a service or product.

                                                                ShortCount of products or services
                                                                Control0..1
                                                                TypeQuantity(SimpleQuantity)
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Required when the product or service code does not convey the quantity provided.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1362. Claim.item:ZusatzpunkteIntensiv.detail.unitPrice
                                                                Definition

                                                                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.

                                                                ShortFee, charge or cost per item
                                                                Control0..1
                                                                TypeMoney
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                The amount charged to the patient by the provider for a single unit.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1364. Claim.item:ZusatzpunkteIntensiv.detail.factor
                                                                Definition

                                                                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.

                                                                ShortPrice scaling factor
                                                                Comments

                                                                To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                Control0..1
                                                                Typedecimal
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1366. Claim.item:ZusatzpunkteIntensiv.detail.tax
                                                                Definition

                                                                The total of taxes applicable for this product or service.

                                                                ShortTotal tax
                                                                Control0..1
                                                                TypeMoney
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Required when taxes are not embedded in the unit price or provided as a separate service.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1368. Claim.item:ZusatzpunkteIntensiv.detail.net
                                                                Definition

                                                                The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                                                ShortTotal item cost
                                                                Comments

                                                                For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                Control0..1
                                                                TypeMoney
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1370. Claim.item:ZusatzpunkteIntensiv.detail.udi
                                                                Definition

                                                                Unique Device Identifiers associated with this line item.

                                                                ShortUnique device identifier
                                                                Control0..*
                                                                TypeReference(Device)
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1372. Claim.item:ZusatzpunkteIntensiv.detail.subDetail
                                                                Definition

                                                                A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                                ShortProduct or service provided
                                                                Control0..*
                                                                TypeBackboneElement
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                The items to be processed for adjudication.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1374. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.id
                                                                Definition

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

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                Typestring
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                1376. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.extension
                                                                Definition

                                                                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.

                                                                ShortAdditional content defined by implementations
                                                                Comments

                                                                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.

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Alternate Namesextensions, user content
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                1378. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.modifierExtension
                                                                Definition

                                                                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).

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

                                                                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.

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                Summarytrue
                                                                Requirements

                                                                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.

                                                                Alternate Namesextensions, user content, modifiers
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                1380. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.sequence
                                                                Definition

                                                                A number to uniquely identify item entries.

                                                                ShortItem instance identifier
                                                                Control1..1
                                                                TypepositiveInt
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1382. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.traceNumber
                                                                Definition

                                                                Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                                ShortNumber for tracking
                                                                Control0..*
                                                                TypeIdentifier
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Allows partners to uniquely identify components for tracking.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1384. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.revenue
                                                                Definition

                                                                The type of revenue or cost center providing the product and/or service.

                                                                ShortRevenue or cost center code
                                                                Control0..1
                                                                BindingFor example codes, see ExampleRevenueCenterCodes
                                                                (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                                Codes for the revenue or cost centers supplying the service and/or products.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Needed in the processing of institutional claims.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1386. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.category
                                                                Definition

                                                                Code to identify the general type of benefits under which products and services are provided.

                                                                ShortBenefit classification
                                                                Comments

                                                                Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                Control0..1
                                                                BindingFor example codes, see BenefitCategoryCodes
                                                                (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                                Benefit categories such as: oral-basic, major, glasses.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                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.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1388. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.productOrService
                                                                Definition

                                                                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.

                                                                ShortBilling, service, product, or drug code
                                                                Comments

                                                                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'.

                                                                Control0..1
                                                                BindingFor example codes, see USCLSCodes
                                                                (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                                Allowable service and product codes.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Necessary to state what was provided or done.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1390. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.productOrServiceEnd
                                                                Definition

                                                                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.

                                                                ShortEnd of a range of codes
                                                                Control0..1
                                                                BindingFor example codes, see USCLSCodes
                                                                (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1392. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.modifier
                                                                Definition

                                                                Item typification or modifiers codes to convey additional context for the product or service.

                                                                ShortService/Product billing modifiers
                                                                Comments

                                                                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.

                                                                Control0..*
                                                                BindingFor example codes, see ModifierTypeCodes
                                                                (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                                Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1394. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.programCode
                                                                Definition

                                                                Identifies the program under which this may be recovered.

                                                                ShortProgram the product or service is provided under
                                                                Comments

                                                                For example: Neonatal program, child dental program or drug users recovery program.

                                                                Control0..*
                                                                BindingFor example codes, see ExampleProgramReasonCodes
                                                                (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                                Program specific reason codes.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1396. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.patientPaid
                                                                Definition

                                                                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.

                                                                ShortPaid by the patient
                                                                Control0..1
                                                                TypeMoney
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1398. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.quantity
                                                                Definition

                                                                The number of repetitions of a service or product.

                                                                ShortCount of products or services
                                                                Control0..1
                                                                TypeQuantity(SimpleQuantity)
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Required when the product or service code does not convey the quantity provided.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1400. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.unitPrice
                                                                Definition

                                                                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.

                                                                ShortFee, charge or cost per item
                                                                Control0..1
                                                                TypeMoney
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                The amount charged to the patient by the provider for a single unit.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1402. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.factor
                                                                Definition

                                                                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.

                                                                ShortPrice scaling factor
                                                                Comments

                                                                To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                Control0..1
                                                                Typedecimal
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1404. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.tax
                                                                Definition

                                                                The total of taxes applicable for this product or service.

                                                                ShortTotal tax
                                                                Control0..1
                                                                TypeMoney
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Required when taxes are not embedded in the unit price or provided as a separate service.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1406. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.net
                                                                Definition

                                                                The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                                                ShortTotal item cost
                                                                Comments

                                                                For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                Control0..1
                                                                TypeMoney
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1408. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.udi
                                                                Definition

                                                                Unique Device Identifiers associated with this line item.

                                                                ShortUnique device identifier
                                                                Control0..*
                                                                TypeReference(Device)
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1410. Claim.item:ZusatzpunkteMehrfachleistungen
                                                                Slice NameZusatzpunkteMehrfachleistungen
                                                                Definition

                                                                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.

                                                                ShortProduct or service provided
                                                                Control0..1
                                                                TypeBackboneElement
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                The items to be processed for adjudication.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1412. Claim.item:ZusatzpunkteMehrfachleistungen.id
                                                                Definition

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

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                Typestring
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                1414. Claim.item:ZusatzpunkteMehrfachleistungen.extension
                                                                Definition

                                                                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.

                                                                ShortAdditional content defined by implementations
                                                                Comments

                                                                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.

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Alternate Namesextensions, user content
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                1416. Claim.item:ZusatzpunkteMehrfachleistungen.modifierExtension
                                                                Definition

                                                                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).

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

                                                                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.

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                Summarytrue
                                                                Requirements

                                                                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.

                                                                Alternate Namesextensions, user content, modifiers
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                1418. Claim.item:ZusatzpunkteMehrfachleistungen.sequence
                                                                Definition

                                                                A number to uniquely identify item entries.

                                                                ShortItem instance identifier
                                                                Control1..1
                                                                TypepositiveInt
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1420. Claim.item:ZusatzpunkteMehrfachleistungen.traceNumber
                                                                Definition

                                                                Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                                ShortNumber for tracking
                                                                Control0..*
                                                                TypeIdentifier
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Allows partners to uniquely identify components for tracking.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1422. Claim.item:ZusatzpunkteMehrfachleistungen.careTeamSequence
                                                                Definition

                                                                CareTeam members related to this service or product.

                                                                ShortApplicable careTeam members
                                                                Control0..*
                                                                TypepositiveInt
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Need to identify the individuals and their roles in the provision of the product or service.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1424. Claim.item:ZusatzpunkteMehrfachleistungen.diagnosisSequence
                                                                Definition

                                                                Diagnosis applicable for this service or product.

                                                                ShortApplicable diagnoses
                                                                Control0..*
                                                                TypepositiveInt
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Need to related the product or service to the associated diagnoses.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1426. Claim.item:ZusatzpunkteMehrfachleistungen.procedureSequence
                                                                Definition

                                                                Procedures applicable for this service or product.

                                                                ShortApplicable procedures
                                                                Control0..*
                                                                TypepositiveInt
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Need to provide any listed specific procedures to support the product or service being claimed.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1428. Claim.item:ZusatzpunkteMehrfachleistungen.informationSequence
                                                                Definition

                                                                Exceptions, special conditions and supporting information applicable for this service or product.

                                                                ShortApplicable exception and supporting information
                                                                Control0..*
                                                                TypepositiveInt
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Need to reference the supporting information items that relate directly to this product or service.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1430. Claim.item:ZusatzpunkteMehrfachleistungen.revenue
                                                                Definition

                                                                The type of revenue or cost center providing the product and/or service.

                                                                ShortRevenue or cost center code
                                                                Control0..1
                                                                BindingFor example codes, see ExampleRevenueCenterCodes
                                                                (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                                Codes for the revenue or cost centers supplying the service and/or products.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Needed in the processing of institutional claims.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1432. Claim.item:ZusatzpunkteMehrfachleistungen.category
                                                                Definition

                                                                Code to identify the general type of benefits under which products and services are provided.

                                                                ShortBenefit classification
                                                                Comments

                                                                Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                Control0..1
                                                                BindingFor example codes, see BenefitCategoryCodes
                                                                (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                                Benefit categories such as: oral-basic, major, glasses.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                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.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1434. Claim.item:ZusatzpunkteMehrfachleistungen.category.id
                                                                Definition

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

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                Typeid
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                1436. Claim.item:ZusatzpunkteMehrfachleistungen.category.extension
                                                                Definition

                                                                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.

                                                                ShortAdditional content defined by implementations
                                                                Comments

                                                                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.

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Alternate Namesextensions, user content
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 1438. Claim.item:ZusatzpunkteMehrfachleistungen.category.coding
                                                                  Definition

                                                                  A reference to a code defined by a terminology system.

                                                                  ShortCode defined by a terminology system
                                                                  Comments

                                                                  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.

                                                                  Control1..*
                                                                  BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                                                  (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                                                  TypeCoding
                                                                  Is Modifierfalse
                                                                  Summarytrue
                                                                  Requirements

                                                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                                                  Pattern Value{
                                                                    "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                                                    "code" : "MELZU"
                                                                  }
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1440. Claim.item:ZusatzpunkteMehrfachleistungen.category.text
                                                                  Definition

                                                                  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.

                                                                  ShortPlain text representation of the concept
                                                                  Comments

                                                                  Very often the text is the same as a displayName of one of the codings.

                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Requirements

                                                                  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.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1442. Claim.item:ZusatzpunkteMehrfachleistungen.productOrService
                                                                  Definition

                                                                  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.

                                                                  ShortBilling, service, product, or drug code
                                                                  Comments

                                                                  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'.

                                                                  Control0..1
                                                                  BindingFor example codes, see USCLSCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                                  Allowable service and product codes.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Necessary to state what was provided or done.

                                                                  Alternate NamesDrug Code, Bill Code, Service Code
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1444. Claim.item:ZusatzpunkteMehrfachleistungen.productOrServiceEnd
                                                                  Definition

                                                                  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.

                                                                  ShortEnd of a range of codes
                                                                  Control0..1
                                                                  BindingFor example codes, see USCLSCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1446. Claim.item:ZusatzpunkteMehrfachleistungen.request
                                                                  Definition

                                                                  Request or Referral for Goods or Service to be rendered.

                                                                  ShortRequest or Referral for Service
                                                                  Control0..*
                                                                  TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  May identify the service to be provided or provider authorization for the service.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1448. Claim.item:ZusatzpunkteMehrfachleistungen.modifier
                                                                  Definition

                                                                  Item typification or modifiers codes to convey additional context for the product or service.

                                                                  ShortProduct or service billing modifiers
                                                                  Comments

                                                                  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.

                                                                  Control0..*
                                                                  BindingFor example codes, see ModifierTypeCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                                  Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1450. Claim.item:ZusatzpunkteMehrfachleistungen.programCode
                                                                  Definition

                                                                  Identifies the program under which this may be recovered.

                                                                  ShortProgram the product or service is provided under
                                                                  Comments

                                                                  For example: Neonatal program, child dental program or drug users recovery program.

                                                                  Control0..*
                                                                  BindingFor example codes, see ExampleProgramReasonCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                                  Program specific reason codes.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1452. Claim.item:ZusatzpunkteMehrfachleistungen.serviced[x]
                                                                  Definition

                                                                  The date or dates when the service or product was supplied, performed or completed.

                                                                  ShortDate or dates of service or product delivery
                                                                  Control0..1
                                                                  TypeChoice of: date, Period
                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1454. Claim.item:ZusatzpunkteMehrfachleistungen.location[x]
                                                                  Definition

                                                                  Where the product or service was provided.

                                                                  ShortPlace of service or where product was supplied
                                                                  Control0..1
                                                                  BindingFor example codes, see ExampleServicePlaceCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/service-place)

                                                                  Place of service: pharmacy, school, prison, etc.

                                                                  TypeChoice of: CodeableConcept, Address, Reference(Location)
                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1456. Claim.item:ZusatzpunkteMehrfachleistungen.patientPaid
                                                                  Definition

                                                                  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.

                                                                  ShortPaid by the patient
                                                                  Control0..1
                                                                  TypeMoney
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1458. Claim.item:ZusatzpunkteMehrfachleistungen.quantity
                                                                  Definition

                                                                  The number of repetitions of a service or product.

                                                                  ShortPunkteanzahl
                                                                  Control1..1
                                                                  TypeQuantity(SimpleQuantity)
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Required when the product or service code does not convey the quantity provided.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1460. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.id
                                                                  Definition

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

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  Typeid
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  1462. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.extension
                                                                  Definition

                                                                  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.

                                                                  ShortAdditional content defined by implementations
                                                                  Comments

                                                                  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.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Alternate Namesextensions, user content
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 1464. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.value
                                                                    Definition

                                                                    The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                    ShortNumerical value (with implicit precision)
                                                                    Comments

                                                                    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).

                                                                    Control1..1
                                                                    Typedecimal
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Requirements

                                                                    Precision is handled implicitly in almost all cases of measurement.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1466. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.comparator
                                                                    Definition

                                                                    Not allowed to be used in this context

                                                                    Short< | <= | >= | > | ad - how to understand the value
                                                                    Control0..0
                                                                    BindingThe codes SHALL be taken from QuantityComparator
                                                                    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                                                    How the Quantity should be understood and represented.

                                                                    Typecode
                                                                    Is Modifiertrue because 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
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Requirements

                                                                    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                    Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1468. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.unit
                                                                    Definition

                                                                    A human-readable form of the unit.

                                                                    ShortUnit representation
                                                                    Control0..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Requirements

                                                                    There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                    Pattern ValueLKF Punkte
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1470. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.system
                                                                    Definition

                                                                    The identification of the system that provides the coded form of the unit.

                                                                    ShortSystem that defines coded unit form
                                                                    Control0..1
                                                                    This element is affected by the following invariants: qty-3
                                                                    Typeuri
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Requirements

                                                                    Need to know the system that defines the coded form of the unit.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1472. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.code
                                                                    Definition

                                                                    A computer processable form of the unit in some unit representation system.

                                                                    ShortCoded form of the unit
                                                                    Comments

                                                                    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.

                                                                    Control0..1
                                                                    This element is affected by the following invariants: qty-3
                                                                    Typecode
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summarytrue
                                                                    Requirements

                                                                    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.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1474. Claim.item:ZusatzpunkteMehrfachleistungen.unitPrice
                                                                    Definition

                                                                    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.

                                                                    ShortFee, charge or cost per item
                                                                    Control0..1
                                                                    TypeMoney
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    The amount charged to the patient by the provider for a single unit.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1476. Claim.item:ZusatzpunkteMehrfachleistungen.factor
                                                                    Definition

                                                                    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.

                                                                    ShortPrice scaling factor
                                                                    Comments

                                                                    To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                    Control0..1
                                                                    Typedecimal
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1478. Claim.item:ZusatzpunkteMehrfachleistungen.tax
                                                                    Definition

                                                                    The total of taxes applicable for this product or service.

                                                                    ShortTotal tax
                                                                    Control0..1
                                                                    TypeMoney
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Required when taxes are not embedded in the unit price or provided as a separate service.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1480. Claim.item:ZusatzpunkteMehrfachleistungen.net
                                                                    Definition

                                                                    The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                                                    ShortTotal item cost
                                                                    Comments

                                                                    For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                    Control0..1
                                                                    TypeMoney
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1482. Claim.item:ZusatzpunkteMehrfachleistungen.udi
                                                                    Definition

                                                                    Unique Device Identifiers associated with this line item.

                                                                    ShortUnique device identifier
                                                                    Control0..*
                                                                    TypeReference(Device)
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1484. Claim.item:ZusatzpunkteMehrfachleistungen.bodySite
                                                                    Definition

                                                                    Physical location where the service is performed or applies.

                                                                    ShortAnatomical location
                                                                    Control0..*
                                                                    TypeBackboneElement
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1486. Claim.item:ZusatzpunkteMehrfachleistungen.bodySite.id
                                                                    Definition

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

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    1488. Claim.item:ZusatzpunkteMehrfachleistungen.bodySite.extension
                                                                    Definition

                                                                    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.

                                                                    ShortAdditional content defined by implementations
                                                                    Comments

                                                                    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.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Alternate Namesextensions, user content
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    1490. Claim.item:ZusatzpunkteMehrfachleistungen.bodySite.modifierExtension
                                                                    Definition

                                                                    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).

                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                    Comments

                                                                    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.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                    Summarytrue
                                                                    Requirements

                                                                    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.

                                                                    Alternate Namesextensions, user content, modifiers
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    1492. Claim.item:ZusatzpunkteMehrfachleistungen.bodySite.site
                                                                    Definition

                                                                    Physical service site on the patient (limb, tooth, etc.).

                                                                    ShortLocation
                                                                    Comments

                                                                    For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                                                    Control1..*
                                                                    BindingFor example codes, see OralSiteCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/tooth)
                                                                    TypeCodeableReference(BodyStructure)
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Allows insurer to validate specific procedures.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1494. Claim.item:ZusatzpunkteMehrfachleistungen.bodySite.subSite
                                                                    Definition

                                                                    A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                                                    ShortSub-location
                                                                    Control0..*
                                                                    BindingFor example codes, see SurfaceCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/surface)
                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Allows insurer to validate specific procedures.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1496. Claim.item:ZusatzpunkteMehrfachleistungen.encounter
                                                                    Definition

                                                                    Healthcare encounters related to this claim.

                                                                    ShortEncounters associated with the listed treatments
                                                                    Comments

                                                                    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.

                                                                    Control0..*
                                                                    TypeReference(Encounter)
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Used in some jurisdictions to link clinical events to claim items.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1498. Claim.item:ZusatzpunkteMehrfachleistungen.detail
                                                                    Definition

                                                                    A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                                    ShortProduct or service provided
                                                                    Control0..*
                                                                    TypeBackboneElement
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    The items to be processed for adjudication.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1500. Claim.item:ZusatzpunkteMehrfachleistungen.detail.id
                                                                    Definition

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

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    1502. Claim.item:ZusatzpunkteMehrfachleistungen.detail.extension
                                                                    Definition

                                                                    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.

                                                                    ShortAdditional content defined by implementations
                                                                    Comments

                                                                    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.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Alternate Namesextensions, user content
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    1504. Claim.item:ZusatzpunkteMehrfachleistungen.detail.modifierExtension
                                                                    Definition

                                                                    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).

                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                    Comments

                                                                    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.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                    Summarytrue
                                                                    Requirements

                                                                    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.

                                                                    Alternate Namesextensions, user content, modifiers
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    1506. Claim.item:ZusatzpunkteMehrfachleistungen.detail.sequence
                                                                    Definition

                                                                    A number to uniquely identify item entries.

                                                                    ShortItem instance identifier
                                                                    Control1..1
                                                                    TypepositiveInt
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1508. Claim.item:ZusatzpunkteMehrfachleistungen.detail.traceNumber
                                                                    Definition

                                                                    Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                                    ShortNumber for tracking
                                                                    Control0..*
                                                                    TypeIdentifier
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Allows partners to uniquely identify components for tracking.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1510. Claim.item:ZusatzpunkteMehrfachleistungen.detail.revenue
                                                                    Definition

                                                                    The type of revenue or cost center providing the product and/or service.

                                                                    ShortRevenue or cost center code
                                                                    Control0..1
                                                                    BindingFor example codes, see ExampleRevenueCenterCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                                    Codes for the revenue or cost centers supplying the service and/or products.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Needed in the processing of institutional claims.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1512. Claim.item:ZusatzpunkteMehrfachleistungen.detail.category
                                                                    Definition

                                                                    Code to identify the general type of benefits under which products and services are provided.

                                                                    ShortBenefit classification
                                                                    Comments

                                                                    Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                    Control0..1
                                                                    BindingFor example codes, see BenefitCategoryCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                                    Benefit categories such as: oral-basic, major, glasses.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    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.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1514. Claim.item:ZusatzpunkteMehrfachleistungen.detail.productOrService
                                                                    Definition

                                                                    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.

                                                                    ShortBilling, service, product, or drug code
                                                                    Comments

                                                                    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'.

                                                                    Control0..1
                                                                    BindingFor example codes, see USCLSCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                                    Allowable service and product codes.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Necessary to state what was provided or done.

                                                                    Alternate NamesDrug Code, Bill Code, Service Code
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1516. Claim.item:ZusatzpunkteMehrfachleistungen.detail.productOrServiceEnd
                                                                    Definition

                                                                    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.

                                                                    ShortEnd of a range of codes
                                                                    Control0..1
                                                                    BindingFor example codes, see USCLSCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1518. Claim.item:ZusatzpunkteMehrfachleistungen.detail.modifier
                                                                    Definition

                                                                    Item typification or modifiers codes to convey additional context for the product or service.

                                                                    ShortService/Product billing modifiers
                                                                    Comments

                                                                    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.

                                                                    Control0..*
                                                                    BindingFor example codes, see ModifierTypeCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                                    Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1520. Claim.item:ZusatzpunkteMehrfachleistungen.detail.programCode
                                                                    Definition

                                                                    Identifies the program under which this may be recovered.

                                                                    ShortProgram the product or service is provided under
                                                                    Comments

                                                                    For example: Neonatal program, child dental program or drug users recovery program.

                                                                    Control0..*
                                                                    BindingFor example codes, see ExampleProgramReasonCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                                    Program specific reason codes.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1522. Claim.item:ZusatzpunkteMehrfachleistungen.detail.patientPaid
                                                                    Definition

                                                                    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.

                                                                    ShortPaid by the patient
                                                                    Control0..1
                                                                    TypeMoney
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1524. Claim.item:ZusatzpunkteMehrfachleistungen.detail.quantity
                                                                    Definition

                                                                    The number of repetitions of a service or product.

                                                                    ShortCount of products or services
                                                                    Control0..1
                                                                    TypeQuantity(SimpleQuantity)
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Required when the product or service code does not convey the quantity provided.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1526. Claim.item:ZusatzpunkteMehrfachleistungen.detail.unitPrice
                                                                    Definition

                                                                    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.

                                                                    ShortFee, charge or cost per item
                                                                    Control0..1
                                                                    TypeMoney
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    The amount charged to the patient by the provider for a single unit.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1528. Claim.item:ZusatzpunkteMehrfachleistungen.detail.factor
                                                                    Definition

                                                                    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.

                                                                    ShortPrice scaling factor
                                                                    Comments

                                                                    To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                    Control0..1
                                                                    Typedecimal
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1530. Claim.item:ZusatzpunkteMehrfachleistungen.detail.tax
                                                                    Definition

                                                                    The total of taxes applicable for this product or service.

                                                                    ShortTotal tax
                                                                    Control0..1
                                                                    TypeMoney
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Required when taxes are not embedded in the unit price or provided as a separate service.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1532. Claim.item:ZusatzpunkteMehrfachleistungen.detail.net
                                                                    Definition

                                                                    The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                                                    ShortTotal item cost
                                                                    Comments

                                                                    For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                    Control0..1
                                                                    TypeMoney
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1534. Claim.item:ZusatzpunkteMehrfachleistungen.detail.udi
                                                                    Definition

                                                                    Unique Device Identifiers associated with this line item.

                                                                    ShortUnique device identifier
                                                                    Control0..*
                                                                    TypeReference(Device)
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1536. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail
                                                                    Definition

                                                                    A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                                    ShortProduct or service provided
                                                                    Control0..*
                                                                    TypeBackboneElement
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    The items to be processed for adjudication.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1538. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.id
                                                                    Definition

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

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    1540. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.extension
                                                                    Definition

                                                                    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.

                                                                    ShortAdditional content defined by implementations
                                                                    Comments

                                                                    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.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Alternate Namesextensions, user content
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    1542. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.modifierExtension
                                                                    Definition

                                                                    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).

                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                    Comments

                                                                    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.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                    Summarytrue
                                                                    Requirements

                                                                    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.

                                                                    Alternate Namesextensions, user content, modifiers
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    1544. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.sequence
                                                                    Definition

                                                                    A number to uniquely identify item entries.

                                                                    ShortItem instance identifier
                                                                    Control1..1
                                                                    TypepositiveInt
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1546. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.traceNumber
                                                                    Definition

                                                                    Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                                    ShortNumber for tracking
                                                                    Control0..*
                                                                    TypeIdentifier
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Allows partners to uniquely identify components for tracking.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1548. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.revenue
                                                                    Definition

                                                                    The type of revenue or cost center providing the product and/or service.

                                                                    ShortRevenue or cost center code
                                                                    Control0..1
                                                                    BindingFor example codes, see ExampleRevenueCenterCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                                    Codes for the revenue or cost centers supplying the service and/or products.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Needed in the processing of institutional claims.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1550. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.category
                                                                    Definition

                                                                    Code to identify the general type of benefits under which products and services are provided.

                                                                    ShortBenefit classification
                                                                    Comments

                                                                    Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                    Control0..1
                                                                    BindingFor example codes, see BenefitCategoryCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                                    Benefit categories such as: oral-basic, major, glasses.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    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.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1552. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.productOrService
                                                                    Definition

                                                                    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.

                                                                    ShortBilling, service, product, or drug code
                                                                    Comments

                                                                    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'.

                                                                    Control0..1
                                                                    BindingFor example codes, see USCLSCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                                    Allowable service and product codes.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Necessary to state what was provided or done.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1554. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.productOrServiceEnd
                                                                    Definition

                                                                    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.

                                                                    ShortEnd of a range of codes
                                                                    Control0..1
                                                                    BindingFor example codes, see USCLSCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1556. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.modifier
                                                                    Definition

                                                                    Item typification or modifiers codes to convey additional context for the product or service.

                                                                    ShortService/Product billing modifiers
                                                                    Comments

                                                                    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.

                                                                    Control0..*
                                                                    BindingFor example codes, see ModifierTypeCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                                    Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1558. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.programCode
                                                                    Definition

                                                                    Identifies the program under which this may be recovered.

                                                                    ShortProgram the product or service is provided under
                                                                    Comments

                                                                    For example: Neonatal program, child dental program or drug users recovery program.

                                                                    Control0..*
                                                                    BindingFor example codes, see ExampleProgramReasonCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                                    Program specific reason codes.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1560. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.patientPaid
                                                                    Definition

                                                                    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.

                                                                    ShortPaid by the patient
                                                                    Control0..1
                                                                    TypeMoney
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1562. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.quantity
                                                                    Definition

                                                                    The number of repetitions of a service or product.

                                                                    ShortCount of products or services
                                                                    Control0..1
                                                                    TypeQuantity(SimpleQuantity)
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Required when the product or service code does not convey the quantity provided.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1564. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.unitPrice
                                                                    Definition

                                                                    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.

                                                                    ShortFee, charge or cost per item
                                                                    Control0..1
                                                                    TypeMoney
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    The amount charged to the patient by the provider for a single unit.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1566. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.factor
                                                                    Definition

                                                                    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.

                                                                    ShortPrice scaling factor
                                                                    Comments

                                                                    To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                    Control0..1
                                                                    Typedecimal
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1568. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.tax
                                                                    Definition

                                                                    The total of taxes applicable for this product or service.

                                                                    ShortTotal tax
                                                                    Control0..1
                                                                    TypeMoney
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Required when taxes are not embedded in the unit price or provided as a separate service.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1570. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.net
                                                                    Definition

                                                                    The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                                                    ShortTotal item cost
                                                                    Comments

                                                                    For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                    Control0..1
                                                                    TypeMoney
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1572. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.udi
                                                                    Definition

                                                                    Unique Device Identifiers associated with this line item.

                                                                    ShortUnique device identifier
                                                                    Control0..*
                                                                    TypeReference(Device)
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1574. Claim.item:PunkteSpeziellerBereicheTageweise
                                                                    Slice NamePunkteSpeziellerBereicheTageweise
                                                                    Definition

                                                                    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.

                                                                    ShortProduct or service provided
                                                                    Control0..1
                                                                    TypeBackboneElement
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    The items to be processed for adjudication.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1576. Claim.item:PunkteSpeziellerBereicheTageweise.id
                                                                    Definition

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

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    1578. Claim.item:PunkteSpeziellerBereicheTageweise.extension
                                                                    Definition

                                                                    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.

                                                                    ShortAdditional content defined by implementations
                                                                    Comments

                                                                    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.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Alternate Namesextensions, user content
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    1580. Claim.item:PunkteSpeziellerBereicheTageweise.modifierExtension
                                                                    Definition

                                                                    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).

                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                    Comments

                                                                    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.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                    Summarytrue
                                                                    Requirements

                                                                    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.

                                                                    Alternate Namesextensions, user content, modifiers
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    1582. Claim.item:PunkteSpeziellerBereicheTageweise.sequence
                                                                    Definition

                                                                    A number to uniquely identify item entries.

                                                                    ShortItem instance identifier
                                                                    Control1..1
                                                                    TypepositiveInt
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1584. Claim.item:PunkteSpeziellerBereicheTageweise.traceNumber
                                                                    Definition

                                                                    Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                                    ShortNumber for tracking
                                                                    Control0..*
                                                                    TypeIdentifier
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Allows partners to uniquely identify components for tracking.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1586. Claim.item:PunkteSpeziellerBereicheTageweise.careTeamSequence
                                                                    Definition

                                                                    CareTeam members related to this service or product.

                                                                    ShortApplicable careTeam members
                                                                    Control0..*
                                                                    TypepositiveInt
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Need to identify the individuals and their roles in the provision of the product or service.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1588. Claim.item:PunkteSpeziellerBereicheTageweise.diagnosisSequence
                                                                    Definition

                                                                    Diagnosis applicable for this service or product.

                                                                    ShortApplicable diagnoses
                                                                    Control0..*
                                                                    TypepositiveInt
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Need to related the product or service to the associated diagnoses.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1590. Claim.item:PunkteSpeziellerBereicheTageweise.procedureSequence
                                                                    Definition

                                                                    Procedures applicable for this service or product.

                                                                    ShortApplicable procedures
                                                                    Control0..*
                                                                    TypepositiveInt
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Need to provide any listed specific procedures to support the product or service being claimed.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1592. Claim.item:PunkteSpeziellerBereicheTageweise.informationSequence
                                                                    Definition

                                                                    Exceptions, special conditions and supporting information applicable for this service or product.

                                                                    ShortApplicable exception and supporting information
                                                                    Control0..*
                                                                    TypepositiveInt
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Need to reference the supporting information items that relate directly to this product or service.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1594. Claim.item:PunkteSpeziellerBereicheTageweise.revenue
                                                                    Definition

                                                                    The type of revenue or cost center providing the product and/or service.

                                                                    ShortRevenue or cost center code
                                                                    Control0..1
                                                                    BindingFor example codes, see ExampleRevenueCenterCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                                    Codes for the revenue or cost centers supplying the service and/or products.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Needed in the processing of institutional claims.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1596. Claim.item:PunkteSpeziellerBereicheTageweise.category
                                                                    Definition

                                                                    Code to identify the general type of benefits under which products and services are provided.

                                                                    ShortBenefit classification
                                                                    Comments

                                                                    Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                    Control0..1
                                                                    BindingFor example codes, see BenefitCategoryCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                                    Benefit categories such as: oral-basic, major, glasses.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supportfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    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.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    1598. Claim.item:PunkteSpeziellerBereicheTageweise.category.id
                                                                    Definition

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

                                                                    ShortUnique id for inter-element referencing
                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    Typeid
                                                                    Is Modifierfalse
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    Summaryfalse
                                                                    1600. Claim.item:PunkteSpeziellerBereicheTageweise.category.extension
                                                                    Definition

                                                                    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.

                                                                    ShortAdditional content defined by implementations
                                                                    Comments

                                                                    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.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Alternate Namesextensions, user content
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                    • 1602. Claim.item:PunkteSpeziellerBereicheTageweise.category.coding
                                                                      Definition

                                                                      A reference to a code defined by a terminology system.

                                                                      ShortCode defined by a terminology system
                                                                      Comments

                                                                      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.

                                                                      Control1..*
                                                                      BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                                                      (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                                                      TypeCoding
                                                                      Is Modifierfalse
                                                                      Summarytrue
                                                                      Requirements

                                                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                                                      Pattern Value{
                                                                        "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                                                        "code" : "SCSPEZ"
                                                                      }
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      1604. Claim.item:PunkteSpeziellerBereicheTageweise.category.text
                                                                      Definition

                                                                      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.

                                                                      ShortPlain text representation of the concept
                                                                      Comments

                                                                      Very often the text is the same as a displayName of one of the codings.

                                                                      Control0..1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summarytrue
                                                                      Requirements

                                                                      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.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      1606. Claim.item:PunkteSpeziellerBereicheTageweise.productOrService
                                                                      Definition

                                                                      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.

                                                                      ShortBilling, service, product, or drug code
                                                                      Comments

                                                                      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'.

                                                                      Control0..1
                                                                      BindingFor example codes, see USCLSCodes
                                                                      (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                                      Allowable service and product codes.

                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Necessary to state what was provided or done.

                                                                      Alternate NamesDrug Code, Bill Code, Service Code
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      1608. Claim.item:PunkteSpeziellerBereicheTageweise.productOrServiceEnd
                                                                      Definition

                                                                      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.

                                                                      ShortEnd of a range of codes
                                                                      Control0..1
                                                                      BindingFor example codes, see USCLSCodes
                                                                      (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      1610. Claim.item:PunkteSpeziellerBereicheTageweise.request
                                                                      Definition

                                                                      Request or Referral for Goods or Service to be rendered.

                                                                      ShortRequest or Referral for Service
                                                                      Control0..*
                                                                      TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                                                      Is Modifierfalse
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Requirements

                                                                      May identify the service to be provided or provider authorization for the service.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      1612. Claim.item:PunkteSpeziellerBereicheTageweise.modifier
                                                                      Definition

                                                                      Item typification or modifiers codes to convey additional context for the product or service.

                                                                      ShortProduct or service billing modifiers
                                                                      Comments

                                                                      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.

                                                                      Control0..*
                                                                      BindingFor example codes, see ModifierTypeCodes
                                                                      (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                                      Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Requirements

                                                                      To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      1614. Claim.item:PunkteSpeziellerBereicheTageweise.programCode
                                                                      Definition

                                                                      Identifies the program under which this may be recovered.

                                                                      ShortProgram the product or service is provided under
                                                                      Comments

                                                                      For example: Neonatal program, child dental program or drug users recovery program.

                                                                      Control0..*
                                                                      BindingFor example codes, see ExampleProgramReasonCodes
                                                                      (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                                      Program specific reason codes.

                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      1616. Claim.item:PunkteSpeziellerBereicheTageweise.serviced[x]
                                                                      Definition

                                                                      The date or dates when the service or product was supplied, performed or completed.

                                                                      ShortDate or dates of service or product delivery
                                                                      Control0..1
                                                                      TypeChoice of: date, Period
                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      1618. Claim.item:PunkteSpeziellerBereicheTageweise.location[x]
                                                                      Definition

                                                                      Where the product or service was provided.

                                                                      ShortPlace of service or where product was supplied
                                                                      Control0..1
                                                                      BindingFor example codes, see ExampleServicePlaceCodes
                                                                      (example to http://hl7.org/fhir/ValueSet/service-place)

                                                                      Place of service: pharmacy, school, prison, etc.

                                                                      TypeChoice of: CodeableConcept, Address, Reference(Location)
                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                      Is Modifierfalse
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Requirements

                                                                      The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      1620. Claim.item:PunkteSpeziellerBereicheTageweise.patientPaid
                                                                      Definition

                                                                      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.

                                                                      ShortPaid by the patient
                                                                      Control0..1
                                                                      TypeMoney
                                                                      Is Modifierfalse
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      1622. Claim.item:PunkteSpeziellerBereicheTageweise.quantity
                                                                      Definition

                                                                      The number of repetitions of a service or product.

                                                                      ShortPunkteanzahl
                                                                      Control1..1
                                                                      TypeQuantity(SimpleQuantity)
                                                                      Is Modifierfalse
                                                                      Must Supportfalse
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Required when the product or service code does not convey the quantity provided.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      1624. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.id
                                                                      Definition

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

                                                                      ShortUnique id for inter-element referencing
                                                                      Control0..1
                                                                      This element is affected by the following invariants: ele-1
                                                                      Typeid
                                                                      Is Modifierfalse
                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                      Summaryfalse
                                                                      1626. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.extension
                                                                      Definition

                                                                      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.

                                                                      ShortAdditional content defined by implementations
                                                                      Comments

                                                                      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.

                                                                      Control0..*
                                                                      TypeExtension
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Alternate Namesextensions, user content
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ url
                                                                      • 1628. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.value
                                                                        Definition

                                                                        The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                        ShortNumerical value (with implicit precision)
                                                                        Comments

                                                                        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).

                                                                        Control1..1
                                                                        Typedecimal
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

                                                                        Precision is handled implicitly in almost all cases of measurement.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1630. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.comparator
                                                                        Definition

                                                                        Not allowed to be used in this context

                                                                        Short< | <= | >= | > | ad - how to understand the value
                                                                        Control0..0
                                                                        BindingThe codes SHALL be taken from QuantityComparator
                                                                        (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                                                        How the Quantity should be understood and represented.

                                                                        Typecode
                                                                        Is Modifiertrue because 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
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

                                                                        Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                        Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1632. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.unit
                                                                        Definition

                                                                        A human-readable form of the unit.

                                                                        ShortUnit representation
                                                                        Control0..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

                                                                        There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                        Pattern ValueLKF Punkte
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1634. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.system
                                                                        Definition

                                                                        The identification of the system that provides the coded form of the unit.

                                                                        ShortSystem that defines coded unit form
                                                                        Control0..1
                                                                        This element is affected by the following invariants: qty-3
                                                                        Typeuri
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

                                                                        Need to know the system that defines the coded form of the unit.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1636. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.code
                                                                        Definition

                                                                        A computer processable form of the unit in some unit representation system.

                                                                        ShortCoded form of the unit
                                                                        Comments

                                                                        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.

                                                                        Control0..1
                                                                        This element is affected by the following invariants: qty-3
                                                                        Typecode
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summarytrue
                                                                        Requirements

                                                                        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.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1638. Claim.item:PunkteSpeziellerBereicheTageweise.unitPrice
                                                                        Definition

                                                                        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.

                                                                        ShortFee, charge or cost per item
                                                                        Control0..1
                                                                        TypeMoney
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        The amount charged to the patient by the provider for a single unit.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1640. Claim.item:PunkteSpeziellerBereicheTageweise.factor
                                                                        Definition

                                                                        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.

                                                                        ShortPrice scaling factor
                                                                        Comments

                                                                        To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                        Control0..1
                                                                        Typedecimal
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1642. Claim.item:PunkteSpeziellerBereicheTageweise.tax
                                                                        Definition

                                                                        The total of taxes applicable for this product or service.

                                                                        ShortTotal tax
                                                                        Control0..1
                                                                        TypeMoney
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Required when taxes are not embedded in the unit price or provided as a separate service.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1644. Claim.item:PunkteSpeziellerBereicheTageweise.net
                                                                        Definition

                                                                        The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                                                        ShortTotal item cost
                                                                        Comments

                                                                        For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                        Control0..1
                                                                        TypeMoney
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1646. Claim.item:PunkteSpeziellerBereicheTageweise.udi
                                                                        Definition

                                                                        Unique Device Identifiers associated with this line item.

                                                                        ShortUnique device identifier
                                                                        Control0..*
                                                                        TypeReference(Device)
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1648. Claim.item:PunkteSpeziellerBereicheTageweise.bodySite
                                                                        Definition

                                                                        Physical location where the service is performed or applies.

                                                                        ShortAnatomical location
                                                                        Control0..*
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1650. Claim.item:PunkteSpeziellerBereicheTageweise.bodySite.id
                                                                        Definition

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

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Summaryfalse
                                                                        1652. Claim.item:PunkteSpeziellerBereicheTageweise.bodySite.extension
                                                                        Definition

                                                                        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.

                                                                        ShortAdditional content defined by implementations
                                                                        Comments

                                                                        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.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Alternate Namesextensions, user content
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        1654. Claim.item:PunkteSpeziellerBereicheTageweise.bodySite.modifierExtension
                                                                        Definition

                                                                        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).

                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                        Comments

                                                                        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.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                        Summarytrue
                                                                        Requirements

                                                                        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.

                                                                        Alternate Namesextensions, user content, modifiers
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        1656. Claim.item:PunkteSpeziellerBereicheTageweise.bodySite.site
                                                                        Definition

                                                                        Physical service site on the patient (limb, tooth, etc.).

                                                                        ShortLocation
                                                                        Comments

                                                                        For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                                                        Control1..*
                                                                        BindingFor example codes, see OralSiteCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/tooth)
                                                                        TypeCodeableReference(BodyStructure)
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Allows insurer to validate specific procedures.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1658. Claim.item:PunkteSpeziellerBereicheTageweise.bodySite.subSite
                                                                        Definition

                                                                        A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                                                        ShortSub-location
                                                                        Control0..*
                                                                        BindingFor example codes, see SurfaceCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/surface)
                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Allows insurer to validate specific procedures.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1660. Claim.item:PunkteSpeziellerBereicheTageweise.encounter
                                                                        Definition

                                                                        Healthcare encounters related to this claim.

                                                                        ShortEncounters associated with the listed treatments
                                                                        Comments

                                                                        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.

                                                                        Control0..*
                                                                        TypeReference(Encounter)
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Used in some jurisdictions to link clinical events to claim items.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1662. Claim.item:PunkteSpeziellerBereicheTageweise.detail
                                                                        Definition

                                                                        A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                                        ShortProduct or service provided
                                                                        Control0..*
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        The items to be processed for adjudication.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1664. Claim.item:PunkteSpeziellerBereicheTageweise.detail.id
                                                                        Definition

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

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Summaryfalse
                                                                        1666. Claim.item:PunkteSpeziellerBereicheTageweise.detail.extension
                                                                        Definition

                                                                        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.

                                                                        ShortAdditional content defined by implementations
                                                                        Comments

                                                                        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.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Alternate Namesextensions, user content
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        1668. Claim.item:PunkteSpeziellerBereicheTageweise.detail.modifierExtension
                                                                        Definition

                                                                        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).

                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                        Comments

                                                                        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.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                        Summarytrue
                                                                        Requirements

                                                                        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.

                                                                        Alternate Namesextensions, user content, modifiers
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        1670. Claim.item:PunkteSpeziellerBereicheTageweise.detail.sequence
                                                                        Definition

                                                                        A number to uniquely identify item entries.

                                                                        ShortItem instance identifier
                                                                        Control1..1
                                                                        TypepositiveInt
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1672. Claim.item:PunkteSpeziellerBereicheTageweise.detail.traceNumber
                                                                        Definition

                                                                        Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                                        ShortNumber for tracking
                                                                        Control0..*
                                                                        TypeIdentifier
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Allows partners to uniquely identify components for tracking.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1674. Claim.item:PunkteSpeziellerBereicheTageweise.detail.revenue
                                                                        Definition

                                                                        The type of revenue or cost center providing the product and/or service.

                                                                        ShortRevenue or cost center code
                                                                        Control0..1
                                                                        BindingFor example codes, see ExampleRevenueCenterCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                                        Codes for the revenue or cost centers supplying the service and/or products.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Needed in the processing of institutional claims.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1676. Claim.item:PunkteSpeziellerBereicheTageweise.detail.category
                                                                        Definition

                                                                        Code to identify the general type of benefits under which products and services are provided.

                                                                        ShortBenefit classification
                                                                        Comments

                                                                        Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                        Control0..1
                                                                        BindingFor example codes, see BenefitCategoryCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                                        Benefit categories such as: oral-basic, major, glasses.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        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.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1678. Claim.item:PunkteSpeziellerBereicheTageweise.detail.productOrService
                                                                        Definition

                                                                        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.

                                                                        ShortBilling, service, product, or drug code
                                                                        Comments

                                                                        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'.

                                                                        Control0..1
                                                                        BindingFor example codes, see USCLSCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                                        Allowable service and product codes.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Necessary to state what was provided or done.

                                                                        Alternate NamesDrug Code, Bill Code, Service Code
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1680. Claim.item:PunkteSpeziellerBereicheTageweise.detail.productOrServiceEnd
                                                                        Definition

                                                                        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.

                                                                        ShortEnd of a range of codes
                                                                        Control0..1
                                                                        BindingFor example codes, see USCLSCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1682. Claim.item:PunkteSpeziellerBereicheTageweise.detail.modifier
                                                                        Definition

                                                                        Item typification or modifiers codes to convey additional context for the product or service.

                                                                        ShortService/Product billing modifiers
                                                                        Comments

                                                                        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.

                                                                        Control0..*
                                                                        BindingFor example codes, see ModifierTypeCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                                        Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1684. Claim.item:PunkteSpeziellerBereicheTageweise.detail.programCode
                                                                        Definition

                                                                        Identifies the program under which this may be recovered.

                                                                        ShortProgram the product or service is provided under
                                                                        Comments

                                                                        For example: Neonatal program, child dental program or drug users recovery program.

                                                                        Control0..*
                                                                        BindingFor example codes, see ExampleProgramReasonCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                                        Program specific reason codes.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1686. Claim.item:PunkteSpeziellerBereicheTageweise.detail.patientPaid
                                                                        Definition

                                                                        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.

                                                                        ShortPaid by the patient
                                                                        Control0..1
                                                                        TypeMoney
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1688. Claim.item:PunkteSpeziellerBereicheTageweise.detail.quantity
                                                                        Definition

                                                                        The number of repetitions of a service or product.

                                                                        ShortCount of products or services
                                                                        Control0..1
                                                                        TypeQuantity(SimpleQuantity)
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Required when the product or service code does not convey the quantity provided.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1690. Claim.item:PunkteSpeziellerBereicheTageweise.detail.unitPrice
                                                                        Definition

                                                                        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.

                                                                        ShortFee, charge or cost per item
                                                                        Control0..1
                                                                        TypeMoney
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        The amount charged to the patient by the provider for a single unit.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1692. Claim.item:PunkteSpeziellerBereicheTageweise.detail.factor
                                                                        Definition

                                                                        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.

                                                                        ShortPrice scaling factor
                                                                        Comments

                                                                        To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                        Control0..1
                                                                        Typedecimal
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1694. Claim.item:PunkteSpeziellerBereicheTageweise.detail.tax
                                                                        Definition

                                                                        The total of taxes applicable for this product or service.

                                                                        ShortTotal tax
                                                                        Control0..1
                                                                        TypeMoney
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Required when taxes are not embedded in the unit price or provided as a separate service.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1696. Claim.item:PunkteSpeziellerBereicheTageweise.detail.net
                                                                        Definition

                                                                        The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                                                        ShortTotal item cost
                                                                        Comments

                                                                        For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                        Control0..1
                                                                        TypeMoney
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1698. Claim.item:PunkteSpeziellerBereicheTageweise.detail.udi
                                                                        Definition

                                                                        Unique Device Identifiers associated with this line item.

                                                                        ShortUnique device identifier
                                                                        Control0..*
                                                                        TypeReference(Device)
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1700. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail
                                                                        Definition

                                                                        A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                                        ShortProduct or service provided
                                                                        Control0..*
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        The items to be processed for adjudication.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1702. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.id
                                                                        Definition

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

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Summaryfalse
                                                                        1704. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.extension
                                                                        Definition

                                                                        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.

                                                                        ShortAdditional content defined by implementations
                                                                        Comments

                                                                        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.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Alternate Namesextensions, user content
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        1706. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.modifierExtension
                                                                        Definition

                                                                        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).

                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                        Comments

                                                                        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.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                        Summarytrue
                                                                        Requirements

                                                                        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.

                                                                        Alternate Namesextensions, user content, modifiers
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        1708. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.sequence
                                                                        Definition

                                                                        A number to uniquely identify item entries.

                                                                        ShortItem instance identifier
                                                                        Control1..1
                                                                        TypepositiveInt
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1710. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.traceNumber
                                                                        Definition

                                                                        Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                                        ShortNumber for tracking
                                                                        Control0..*
                                                                        TypeIdentifier
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Allows partners to uniquely identify components for tracking.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1712. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.revenue
                                                                        Definition

                                                                        The type of revenue or cost center providing the product and/or service.

                                                                        ShortRevenue or cost center code
                                                                        Control0..1
                                                                        BindingFor example codes, see ExampleRevenueCenterCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                                        Codes for the revenue or cost centers supplying the service and/or products.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Needed in the processing of institutional claims.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1714. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.category
                                                                        Definition

                                                                        Code to identify the general type of benefits under which products and services are provided.

                                                                        ShortBenefit classification
                                                                        Comments

                                                                        Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                        Control0..1
                                                                        BindingFor example codes, see BenefitCategoryCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                                        Benefit categories such as: oral-basic, major, glasses.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        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.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1716. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.productOrService
                                                                        Definition

                                                                        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.

                                                                        ShortBilling, service, product, or drug code
                                                                        Comments

                                                                        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'.

                                                                        Control0..1
                                                                        BindingFor example codes, see USCLSCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                                        Allowable service and product codes.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Necessary to state what was provided or done.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1718. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.productOrServiceEnd
                                                                        Definition

                                                                        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.

                                                                        ShortEnd of a range of codes
                                                                        Control0..1
                                                                        BindingFor example codes, see USCLSCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1720. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.modifier
                                                                        Definition

                                                                        Item typification or modifiers codes to convey additional context for the product or service.

                                                                        ShortService/Product billing modifiers
                                                                        Comments

                                                                        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.

                                                                        Control0..*
                                                                        BindingFor example codes, see ModifierTypeCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                                        Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1722. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.programCode
                                                                        Definition

                                                                        Identifies the program under which this may be recovered.

                                                                        ShortProgram the product or service is provided under
                                                                        Comments

                                                                        For example: Neonatal program, child dental program or drug users recovery program.

                                                                        Control0..*
                                                                        BindingFor example codes, see ExampleProgramReasonCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                                        Program specific reason codes.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1724. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.patientPaid
                                                                        Definition

                                                                        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.

                                                                        ShortPaid by the patient
                                                                        Control0..1
                                                                        TypeMoney
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1726. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.quantity
                                                                        Definition

                                                                        The number of repetitions of a service or product.

                                                                        ShortCount of products or services
                                                                        Control0..1
                                                                        TypeQuantity(SimpleQuantity)
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Required when the product or service code does not convey the quantity provided.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1728. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.unitPrice
                                                                        Definition

                                                                        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.

                                                                        ShortFee, charge or cost per item
                                                                        Control0..1
                                                                        TypeMoney
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        The amount charged to the patient by the provider for a single unit.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1730. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.factor
                                                                        Definition

                                                                        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.

                                                                        ShortPrice scaling factor
                                                                        Comments

                                                                        To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                        Control0..1
                                                                        Typedecimal
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1732. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.tax
                                                                        Definition

                                                                        The total of taxes applicable for this product or service.

                                                                        ShortTotal tax
                                                                        Control0..1
                                                                        TypeMoney
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Required when taxes are not embedded in the unit price or provided as a separate service.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1734. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.net
                                                                        Definition

                                                                        The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                                                        ShortTotal item cost
                                                                        Comments

                                                                        For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                        Control0..1
                                                                        TypeMoney
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1736. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.udi
                                                                        Definition

                                                                        Unique Device Identifiers associated with this line item.

                                                                        ShortUnique device identifier
                                                                        Control0..*
                                                                        TypeReference(Device)
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1738. Claim.item:Gesamtpunkte
                                                                        Slice NameGesamtpunkte
                                                                        Definition

                                                                        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.

                                                                        ShortProduct or service provided
                                                                        Control1..1
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        The items to be processed for adjudication.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1740. Claim.item:Gesamtpunkte.id
                                                                        Definition

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

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Summaryfalse
                                                                        1742. Claim.item:Gesamtpunkte.extension
                                                                        Definition

                                                                        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.

                                                                        ShortAdditional content defined by implementations
                                                                        Comments

                                                                        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.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Alternate Namesextensions, user content
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        1744. Claim.item:Gesamtpunkte.modifierExtension
                                                                        Definition

                                                                        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).

                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                        Comments

                                                                        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.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                        Summarytrue
                                                                        Requirements

                                                                        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.

                                                                        Alternate Namesextensions, user content, modifiers
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        1746. Claim.item:Gesamtpunkte.sequence
                                                                        Definition

                                                                        A number to uniquely identify item entries.

                                                                        ShortItem instance identifier
                                                                        Control1..1
                                                                        TypepositiveInt
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1748. Claim.item:Gesamtpunkte.traceNumber
                                                                        Definition

                                                                        Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                                        ShortNumber for tracking
                                                                        Control0..*
                                                                        TypeIdentifier
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Allows partners to uniquely identify components for tracking.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1750. Claim.item:Gesamtpunkte.careTeamSequence
                                                                        Definition

                                                                        CareTeam members related to this service or product.

                                                                        ShortApplicable careTeam members
                                                                        Control0..*
                                                                        TypepositiveInt
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Need to identify the individuals and their roles in the provision of the product or service.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1752. Claim.item:Gesamtpunkte.diagnosisSequence
                                                                        Definition

                                                                        Diagnosis applicable for this service or product.

                                                                        ShortApplicable diagnoses
                                                                        Control0..*
                                                                        TypepositiveInt
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Need to related the product or service to the associated diagnoses.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1754. Claim.item:Gesamtpunkte.procedureSequence
                                                                        Definition

                                                                        Procedures applicable for this service or product.

                                                                        ShortApplicable procedures
                                                                        Control0..*
                                                                        TypepositiveInt
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Need to provide any listed specific procedures to support the product or service being claimed.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1756. Claim.item:Gesamtpunkte.informationSequence
                                                                        Definition

                                                                        Exceptions, special conditions and supporting information applicable for this service or product.

                                                                        ShortApplicable exception and supporting information
                                                                        Control0..*
                                                                        TypepositiveInt
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Need to reference the supporting information items that relate directly to this product or service.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1758. Claim.item:Gesamtpunkte.revenue
                                                                        Definition

                                                                        The type of revenue or cost center providing the product and/or service.

                                                                        ShortRevenue or cost center code
                                                                        Control0..1
                                                                        BindingFor example codes, see ExampleRevenueCenterCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                                        Codes for the revenue or cost centers supplying the service and/or products.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Needed in the processing of institutional claims.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1760. Claim.item:Gesamtpunkte.category
                                                                        Definition

                                                                        Code to identify the general type of benefits under which products and services are provided.

                                                                        ShortBenefit classification
                                                                        Comments

                                                                        Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                        Control0..1
                                                                        BindingFor example codes, see BenefitCategoryCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                                        Benefit categories such as: oral-basic, major, glasses.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supportfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        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.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        1762. Claim.item:Gesamtpunkte.category.id
                                                                        Definition

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

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        This element is affected by the following invariants: ele-1
                                                                        Typeid
                                                                        Is Modifierfalse
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Summaryfalse
                                                                        1764. Claim.item:Gesamtpunkte.category.extension
                                                                        Definition

                                                                        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.

                                                                        ShortAdditional content defined by implementations
                                                                        Comments

                                                                        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.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Alternate Namesextensions, user content
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 1766. Claim.item:Gesamtpunkte.category.coding
                                                                          Definition

                                                                          A reference to a code defined by a terminology system.

                                                                          ShortCode defined by a terminology system
                                                                          Comments

                                                                          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.

                                                                          Control1..*
                                                                          BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                                                          (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                                                          TypeCoding
                                                                          Is Modifierfalse
                                                                          Summarytrue
                                                                          Requirements

                                                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                                                          Pattern Value{
                                                                            "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                                                            "code" : "SCGES"
                                                                          }
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          1768. Claim.item:Gesamtpunkte.category.text
                                                                          Definition

                                                                          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.

                                                                          ShortPlain text representation of the concept
                                                                          Comments

                                                                          Very often the text is the same as a displayName of one of the codings.

                                                                          Control0..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          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.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          1770. Claim.item:Gesamtpunkte.productOrService
                                                                          Definition

                                                                          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.

                                                                          ShortBilling, service, product, or drug code
                                                                          Comments

                                                                          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'.

                                                                          Control0..1
                                                                          BindingFor example codes, see USCLSCodes
                                                                          (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                                          Allowable service and product codes.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Necessary to state what was provided or done.

                                                                          Alternate NamesDrug Code, Bill Code, Service Code
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          1772. Claim.item:Gesamtpunkte.productOrServiceEnd
                                                                          Definition

                                                                          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.

                                                                          ShortEnd of a range of codes
                                                                          Control0..1
                                                                          BindingFor example codes, see USCLSCodes
                                                                          (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          1774. Claim.item:Gesamtpunkte.request
                                                                          Definition

                                                                          Request or Referral for Goods or Service to be rendered.

                                                                          ShortRequest or Referral for Service
                                                                          Control0..*
                                                                          TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                                                          Is Modifierfalse
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          May identify the service to be provided or provider authorization for the service.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          1776. Claim.item:Gesamtpunkte.modifier
                                                                          Definition

                                                                          Item typification or modifiers codes to convey additional context for the product or service.

                                                                          ShortProduct or service billing modifiers
                                                                          Comments

                                                                          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.

                                                                          Control0..*
                                                                          BindingFor example codes, see ModifierTypeCodes
                                                                          (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                                          Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          1778. Claim.item:Gesamtpunkte.programCode
                                                                          Definition

                                                                          Identifies the program under which this may be recovered.

                                                                          ShortProgram the product or service is provided under
                                                                          Comments

                                                                          For example: Neonatal program, child dental program or drug users recovery program.

                                                                          Control0..*
                                                                          BindingFor example codes, see ExampleProgramReasonCodes
                                                                          (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                                          Program specific reason codes.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          1780. Claim.item:Gesamtpunkte.serviced[x]
                                                                          Definition

                                                                          The date or dates when the service or product was supplied, performed or completed.

                                                                          ShortDate or dates of service or product delivery
                                                                          Control0..1
                                                                          TypeChoice of: date, Period
                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          1782. Claim.item:Gesamtpunkte.location[x]
                                                                          Definition

                                                                          Where the product or service was provided.

                                                                          ShortPlace of service or where product was supplied
                                                                          Control0..1
                                                                          BindingFor example codes, see ExampleServicePlaceCodes
                                                                          (example to http://hl7.org/fhir/ValueSet/service-place)

                                                                          Place of service: pharmacy, school, prison, etc.

                                                                          TypeChoice of: CodeableConcept, Address, Reference(Location)
                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                          Is Modifierfalse
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          1784. Claim.item:Gesamtpunkte.patientPaid
                                                                          Definition

                                                                          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.

                                                                          ShortPaid by the patient
                                                                          Control0..1
                                                                          TypeMoney
                                                                          Is Modifierfalse
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          1786. Claim.item:Gesamtpunkte.quantity
                                                                          Definition

                                                                          The number of repetitions of a service or product.

                                                                          ShortPunkteanzahl
                                                                          Control1..1
                                                                          TypeQuantity(SimpleQuantity)
                                                                          Is Modifierfalse
                                                                          Must Supportfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Required when the product or service code does not convey the quantity provided.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          1788. Claim.item:Gesamtpunkte.quantity.id
                                                                          Definition

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

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          Typeid
                                                                          Is Modifierfalse
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          Summaryfalse
                                                                          1790. Claim.item:Gesamtpunkte.quantity.extension
                                                                          Definition

                                                                          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.

                                                                          ShortAdditional content defined by implementations
                                                                          Comments

                                                                          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.

                                                                          Control0..*
                                                                          TypeExtension
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Alternate Namesextensions, user content
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 1792. Claim.item:Gesamtpunkte.quantity.value
                                                                            Definition

                                                                            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                            ShortNumerical value (with implicit precision)
                                                                            Comments

                                                                            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).

                                                                            Control1..1
                                                                            Typedecimal
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

                                                                            Precision is handled implicitly in almost all cases of measurement.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1794. Claim.item:Gesamtpunkte.quantity.comparator
                                                                            Definition

                                                                            Not allowed to be used in this context

                                                                            Short< | <= | >= | > | ad - how to understand the value
                                                                            Control0..0
                                                                            BindingThe codes SHALL be taken from QuantityComparator
                                                                            (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                                                            How the Quantity should be understood and represented.

                                                                            Typecode
                                                                            Is Modifiertrue because 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
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

                                                                            Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                            Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1796. Claim.item:Gesamtpunkte.quantity.unit
                                                                            Definition

                                                                            A human-readable form of the unit.

                                                                            ShortUnit representation
                                                                            Control0..1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

                                                                            There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                            Pattern ValueLKF Punkte
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1798. Claim.item:Gesamtpunkte.quantity.system
                                                                            Definition

                                                                            The identification of the system that provides the coded form of the unit.

                                                                            ShortSystem that defines coded unit form
                                                                            Control0..1
                                                                            This element is affected by the following invariants: qty-3
                                                                            Typeuri
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

                                                                            Need to know the system that defines the coded form of the unit.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1800. Claim.item:Gesamtpunkte.quantity.code
                                                                            Definition

                                                                            A computer processable form of the unit in some unit representation system.

                                                                            ShortCoded form of the unit
                                                                            Comments

                                                                            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.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: qty-3
                                                                            Typecode
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

                                                                            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.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1802. Claim.item:Gesamtpunkte.unitPrice
                                                                            Definition

                                                                            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.

                                                                            ShortFee, charge or cost per item
                                                                            Control0..1
                                                                            TypeMoney
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            The amount charged to the patient by the provider for a single unit.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1804. Claim.item:Gesamtpunkte.factor
                                                                            Definition

                                                                            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.

                                                                            ShortPrice scaling factor
                                                                            Comments

                                                                            To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                            Control0..1
                                                                            Typedecimal
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1806. Claim.item:Gesamtpunkte.tax
                                                                            Definition

                                                                            The total of taxes applicable for this product or service.

                                                                            ShortTotal tax
                                                                            Control0..1
                                                                            TypeMoney
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Required when taxes are not embedded in the unit price or provided as a separate service.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1808. Claim.item:Gesamtpunkte.net
                                                                            Definition

                                                                            The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                                                            ShortTotal item cost
                                                                            Comments

                                                                            For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                            Control0..1
                                                                            TypeMoney
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1810. Claim.item:Gesamtpunkte.udi
                                                                            Definition

                                                                            Unique Device Identifiers associated with this line item.

                                                                            ShortUnique device identifier
                                                                            Control0..*
                                                                            TypeReference(Device)
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1812. Claim.item:Gesamtpunkte.bodySite
                                                                            Definition

                                                                            Physical location where the service is performed or applies.

                                                                            ShortAnatomical location
                                                                            Control0..*
                                                                            TypeBackboneElement
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1814. Claim.item:Gesamtpunkte.bodySite.id
                                                                            Definition

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

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Summaryfalse
                                                                            1816. Claim.item:Gesamtpunkte.bodySite.extension
                                                                            Definition

                                                                            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.

                                                                            ShortAdditional content defined by implementations
                                                                            Comments

                                                                            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.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Alternate Namesextensions, user content
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            1818. Claim.item:Gesamtpunkte.bodySite.modifierExtension
                                                                            Definition

                                                                            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).

                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                            Comments

                                                                            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.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                            Summarytrue
                                                                            Requirements

                                                                            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.

                                                                            Alternate Namesextensions, user content, modifiers
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            1820. Claim.item:Gesamtpunkte.bodySite.site
                                                                            Definition

                                                                            Physical service site on the patient (limb, tooth, etc.).

                                                                            ShortLocation
                                                                            Comments

                                                                            For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                                                            Control1..*
                                                                            BindingFor example codes, see OralSiteCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/tooth)
                                                                            TypeCodeableReference(BodyStructure)
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Allows insurer to validate specific procedures.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1822. Claim.item:Gesamtpunkte.bodySite.subSite
                                                                            Definition

                                                                            A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                                                            ShortSub-location
                                                                            Control0..*
                                                                            BindingFor example codes, see SurfaceCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/surface)
                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Allows insurer to validate specific procedures.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1824. Claim.item:Gesamtpunkte.encounter
                                                                            Definition

                                                                            Healthcare encounters related to this claim.

                                                                            ShortEncounters associated with the listed treatments
                                                                            Comments

                                                                            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.

                                                                            Control0..*
                                                                            TypeReference(Encounter)
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Used in some jurisdictions to link clinical events to claim items.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1826. Claim.item:Gesamtpunkte.detail
                                                                            Definition

                                                                            A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                                            ShortProduct or service provided
                                                                            Control0..*
                                                                            TypeBackboneElement
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            The items to be processed for adjudication.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1828. Claim.item:Gesamtpunkte.detail.id
                                                                            Definition

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

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Summaryfalse
                                                                            1830. Claim.item:Gesamtpunkte.detail.extension
                                                                            Definition

                                                                            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.

                                                                            ShortAdditional content defined by implementations
                                                                            Comments

                                                                            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.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Alternate Namesextensions, user content
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            1832. Claim.item:Gesamtpunkte.detail.modifierExtension
                                                                            Definition

                                                                            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).

                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                            Comments

                                                                            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.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                            Summarytrue
                                                                            Requirements

                                                                            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.

                                                                            Alternate Namesextensions, user content, modifiers
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            1834. Claim.item:Gesamtpunkte.detail.sequence
                                                                            Definition

                                                                            A number to uniquely identify item entries.

                                                                            ShortItem instance identifier
                                                                            Control1..1
                                                                            TypepositiveInt
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1836. Claim.item:Gesamtpunkte.detail.traceNumber
                                                                            Definition

                                                                            Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                                            ShortNumber for tracking
                                                                            Control0..*
                                                                            TypeIdentifier
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Allows partners to uniquely identify components for tracking.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1838. Claim.item:Gesamtpunkte.detail.revenue
                                                                            Definition

                                                                            The type of revenue or cost center providing the product and/or service.

                                                                            ShortRevenue or cost center code
                                                                            Control0..1
                                                                            BindingFor example codes, see ExampleRevenueCenterCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                                            Codes for the revenue or cost centers supplying the service and/or products.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Needed in the processing of institutional claims.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1840. Claim.item:Gesamtpunkte.detail.category
                                                                            Definition

                                                                            Code to identify the general type of benefits under which products and services are provided.

                                                                            ShortBenefit classification
                                                                            Comments

                                                                            Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                            Control0..1
                                                                            BindingFor example codes, see BenefitCategoryCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                                            Benefit categories such as: oral-basic, major, glasses.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            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.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1842. Claim.item:Gesamtpunkte.detail.productOrService
                                                                            Definition

                                                                            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.

                                                                            ShortBilling, service, product, or drug code
                                                                            Comments

                                                                            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'.

                                                                            Control0..1
                                                                            BindingFor example codes, see USCLSCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                                            Allowable service and product codes.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Necessary to state what was provided or done.

                                                                            Alternate NamesDrug Code, Bill Code, Service Code
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1844. Claim.item:Gesamtpunkte.detail.productOrServiceEnd
                                                                            Definition

                                                                            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.

                                                                            ShortEnd of a range of codes
                                                                            Control0..1
                                                                            BindingFor example codes, see USCLSCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1846. Claim.item:Gesamtpunkte.detail.modifier
                                                                            Definition

                                                                            Item typification or modifiers codes to convey additional context for the product or service.

                                                                            ShortService/Product billing modifiers
                                                                            Comments

                                                                            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.

                                                                            Control0..*
                                                                            BindingFor example codes, see ModifierTypeCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                                            Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1848. Claim.item:Gesamtpunkte.detail.programCode
                                                                            Definition

                                                                            Identifies the program under which this may be recovered.

                                                                            ShortProgram the product or service is provided under
                                                                            Comments

                                                                            For example: Neonatal program, child dental program or drug users recovery program.

                                                                            Control0..*
                                                                            BindingFor example codes, see ExampleProgramReasonCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                                            Program specific reason codes.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1850. Claim.item:Gesamtpunkte.detail.patientPaid
                                                                            Definition

                                                                            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.

                                                                            ShortPaid by the patient
                                                                            Control0..1
                                                                            TypeMoney
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1852. Claim.item:Gesamtpunkte.detail.quantity
                                                                            Definition

                                                                            The number of repetitions of a service or product.

                                                                            ShortCount of products or services
                                                                            Control0..1
                                                                            TypeQuantity(SimpleQuantity)
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Required when the product or service code does not convey the quantity provided.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1854. Claim.item:Gesamtpunkte.detail.unitPrice
                                                                            Definition

                                                                            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.

                                                                            ShortFee, charge or cost per item
                                                                            Control0..1
                                                                            TypeMoney
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            The amount charged to the patient by the provider for a single unit.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1856. Claim.item:Gesamtpunkte.detail.factor
                                                                            Definition

                                                                            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.

                                                                            ShortPrice scaling factor
                                                                            Comments

                                                                            To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                            Control0..1
                                                                            Typedecimal
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1858. Claim.item:Gesamtpunkte.detail.tax
                                                                            Definition

                                                                            The total of taxes applicable for this product or service.

                                                                            ShortTotal tax
                                                                            Control0..1
                                                                            TypeMoney
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Required when taxes are not embedded in the unit price or provided as a separate service.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1860. Claim.item:Gesamtpunkte.detail.net
                                                                            Definition

                                                                            The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                                                            ShortTotal item cost
                                                                            Comments

                                                                            For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                            Control0..1
                                                                            TypeMoney
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1862. Claim.item:Gesamtpunkte.detail.udi
                                                                            Definition

                                                                            Unique Device Identifiers associated with this line item.

                                                                            ShortUnique device identifier
                                                                            Control0..*
                                                                            TypeReference(Device)
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1864. Claim.item:Gesamtpunkte.detail.subDetail
                                                                            Definition

                                                                            A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                                            ShortProduct or service provided
                                                                            Control0..*
                                                                            TypeBackboneElement
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            The items to be processed for adjudication.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1866. Claim.item:Gesamtpunkte.detail.subDetail.id
                                                                            Definition

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

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Summaryfalse
                                                                            1868. Claim.item:Gesamtpunkte.detail.subDetail.extension
                                                                            Definition

                                                                            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.

                                                                            ShortAdditional content defined by implementations
                                                                            Comments

                                                                            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.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Alternate Namesextensions, user content
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            1870. Claim.item:Gesamtpunkte.detail.subDetail.modifierExtension
                                                                            Definition

                                                                            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).

                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                            Comments

                                                                            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.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                            Summarytrue
                                                                            Requirements

                                                                            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.

                                                                            Alternate Namesextensions, user content, modifiers
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            1872. Claim.item:Gesamtpunkte.detail.subDetail.sequence
                                                                            Definition

                                                                            A number to uniquely identify item entries.

                                                                            ShortItem instance identifier
                                                                            Control1..1
                                                                            TypepositiveInt
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1874. Claim.item:Gesamtpunkte.detail.subDetail.traceNumber
                                                                            Definition

                                                                            Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                                            ShortNumber for tracking
                                                                            Control0..*
                                                                            TypeIdentifier
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Allows partners to uniquely identify components for tracking.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1876. Claim.item:Gesamtpunkte.detail.subDetail.revenue
                                                                            Definition

                                                                            The type of revenue or cost center providing the product and/or service.

                                                                            ShortRevenue or cost center code
                                                                            Control0..1
                                                                            BindingFor example codes, see ExampleRevenueCenterCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/ex-revenue-center)

                                                                            Codes for the revenue or cost centers supplying the service and/or products.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Needed in the processing of institutional claims.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1878. Claim.item:Gesamtpunkte.detail.subDetail.category
                                                                            Definition

                                                                            Code to identify the general type of benefits under which products and services are provided.

                                                                            ShortBenefit classification
                                                                            Comments

                                                                            Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                            Control0..1
                                                                            BindingFor example codes, see BenefitCategoryCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory)

                                                                            Benefit categories such as: oral-basic, major, glasses.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            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.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1880. Claim.item:Gesamtpunkte.detail.subDetail.productOrService
                                                                            Definition

                                                                            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.

                                                                            ShortBilling, service, product, or drug code
                                                                            Comments

                                                                            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'.

                                                                            Control0..1
                                                                            BindingFor example codes, see USCLSCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                                            Allowable service and product codes.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Necessary to state what was provided or done.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1882. Claim.item:Gesamtpunkte.detail.subDetail.productOrServiceEnd
                                                                            Definition

                                                                            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.

                                                                            ShortEnd of a range of codes
                                                                            Control0..1
                                                                            BindingFor example codes, see USCLSCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/service-uscls)
                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1884. Claim.item:Gesamtpunkte.detail.subDetail.modifier
                                                                            Definition

                                                                            Item typification or modifiers codes to convey additional context for the product or service.

                                                                            ShortService/Product billing modifiers
                                                                            Comments

                                                                            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.

                                                                            Control0..*
                                                                            BindingFor example codes, see ModifierTypeCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/claim-modifiers)

                                                                            Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1886. Claim.item:Gesamtpunkte.detail.subDetail.programCode
                                                                            Definition

                                                                            Identifies the program under which this may be recovered.

                                                                            ShortProgram the product or service is provided under
                                                                            Comments

                                                                            For example: Neonatal program, child dental program or drug users recovery program.

                                                                            Control0..*
                                                                            BindingFor example codes, see ExampleProgramReasonCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/ex-program-code)

                                                                            Program specific reason codes.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1888. Claim.item:Gesamtpunkte.detail.subDetail.patientPaid
                                                                            Definition

                                                                            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.

                                                                            ShortPaid by the patient
                                                                            Control0..1
                                                                            TypeMoney
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1890. Claim.item:Gesamtpunkte.detail.subDetail.quantity
                                                                            Definition

                                                                            The number of repetitions of a service or product.

                                                                            ShortCount of products or services
                                                                            Control0..1
                                                                            TypeQuantity(SimpleQuantity)
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Required when the product or service code does not convey the quantity provided.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1892. Claim.item:Gesamtpunkte.detail.subDetail.unitPrice
                                                                            Definition

                                                                            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.

                                                                            ShortFee, charge or cost per item
                                                                            Control0..1
                                                                            TypeMoney
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            The amount charged to the patient by the provider for a single unit.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1894. Claim.item:Gesamtpunkte.detail.subDetail.factor
                                                                            Definition

                                                                            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.

                                                                            ShortPrice scaling factor
                                                                            Comments

                                                                            To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                            Control0..1
                                                                            Typedecimal
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1896. Claim.item:Gesamtpunkte.detail.subDetail.tax
                                                                            Definition

                                                                            The total of taxes applicable for this product or service.

                                                                            ShortTotal tax
                                                                            Control0..1
                                                                            TypeMoney
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Required when taxes are not embedded in the unit price or provided as a separate service.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1898. Claim.item:Gesamtpunkte.detail.subDetail.net
                                                                            Definition

                                                                            The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                                                            ShortTotal item cost
                                                                            Comments

                                                                            For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                            Control0..1
                                                                            TypeMoney
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1900. Claim.item:Gesamtpunkte.detail.subDetail.udi
                                                                            Definition

                                                                            Unique Device Identifiers associated with this line item.

                                                                            ShortUnique device identifier
                                                                            Control0..*
                                                                            TypeReference(Device)
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            1902. Claim.total
                                                                            Definition

                                                                            The total value of the all the items in the claim.

                                                                            ShortTotal claim cost
                                                                            Control0..1
                                                                            TypeMoney
                                                                            Is Modifierfalse
                                                                            Must Supportfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Used for control total purposes.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))