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 2025-10-31

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.

Control20..*
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.

    ShortLKF: Abrechnung – Knoten
    Control1..1
    TypeExtension(Abrechnung - Knoten) (Extension Type: Coding)
    Is Modifierfalse
    Must Supportfalse
    Obligations
      ObligationsActor
      SHALL:populateMoped KH Actor
      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
      Obligations
        ObligationsActor
        SHALL:populateMoped KH Actor
        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.extension:Fondsrelevanz
        Slice NameFondsrelevanz
        Definition

        Hier ist anzugeben, ob der stationäre Aufenthalt/ambulante Besuch gegenüber dem Landesgesundheitsfonds/PRIKRAF abzurechnen ist.

        ShortFondsrelevanz
        Control1..1
        TypeExtension(Fondsrelevanz) (Extension Type: Coding)
        Is Modifierfalse
        Must Supportfalse
        Obligations
          ObligationsActor
          SHALL:populateMoped KH Actor
          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())
          14. 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())
          16. 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
          Obligations
            ObligationsActor
            SHALL:populateMoped KH Actor
            SHALL:handleMoped Device Actor
            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()))
            18. 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|5.0.0
            (extensible to http://hl7.org/fhir/ValueSet/claim-type|5.0.0)

            The type or discipline-style of the claim.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supportfalse
            Obligations
              ObligationsActor
              SHALL:populateMoped KH Actor
              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()))
              20. 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
              Obligations
                ObligationsActor
                SHALL:populateMoped KH Actor
                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()))
                22. 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
                Obligations
                  ObligationsActor
                  SHALL:handleMoped Device Actor
                  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()))
                  24. 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()))
                  26. Claim.insurer
                  Definition

                  The Insurer who is target of the request.

                  ShortTarget
                  Control10..1
                  TypeReference(SV Organization, Organization)
                  Is Modifierfalse
                  Must Supportfalse
                  Obligations
                    ObligationsActor
                    SHALL:handleMoped Device Actor
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    28. 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
                    Obligations
                      ObligationsActor
                      SHALL:handleMoped Device Actor
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      30. 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()
                      • 32. 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
                        Obligations
                          ObligationsActor
                          SHALL:handleMoped Device Actor
                          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.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
                          Obligations
                            ObligationsActor
                            SHALL:handleMoped Device Actor
                            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()))
                            36. 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.

                            ShortLKF: Abrechnung - GruppePackage 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|5.0.0
                            (required to https://elga.moped.at/ValueSet/LKFAbrechnungsGruppeVS)
                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supportfalse
                            Obligations
                              ObligationsActor
                              SHALL:populateMoped KH Actor
                              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()))
                              38. 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.

                              Control20..*
                              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
                              • 40. 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())
                                42. 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()))
                                44. 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|5.0.0
                                (example to http://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0)

                                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()))
                                46. 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
                                Obligations
                                  ObligationsActor
                                  SHALL:populateMoped KH Actor
                                  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()))
                                  48. 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())
                                  50. 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()))
                                  52. 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|5.0.0
                                  (example to http://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0)

                                  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()))
                                  54. 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()))
                                  56. Claim.supportingInfo:EndgueltigeMeldung
                                  Slice NameEndgueltigeMeldung
                                  Definition

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

                                  ShortFeld, welches angibt, ob es sich um die vorläufige oder endgültige Meldung handelt.Supporting information
                                  Comments

                                  Often there are multiple jurisdiction specific valuesets which are required.

                                  Control10..1*
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Obligations
                                    ObligationsActor
                                    SHALL:populateMoped KH Actor
                                    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()))
                                    58. Claim.supportingInfo:EndgueltigeMeldung.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())
                                    60. Claim.supportingInfo:EndgueltigeMeldung.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()))
                                    62. Claim.supportingInfo:EndgueltigeMeldung.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|5.0.0
                                    (example to http://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0)

                                    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" : "ENDG"
                                      }]
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    64. Claim.supportingInfo:EndgueltigeMeldung.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
                                    Typeboolean, Identifier, string, 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()))
                                    66. 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
                                    • 68. 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())
                                      70. 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()))
                                      72. 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.

                                      ShortLKF: Leistungskomponente/LeistungspunkteProduct or service provided
                                      Control10..1*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Obligations
                                        ObligationsActor
                                        SHALL:populateMoped KH Actor
                                        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()))
                                        74. 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())
                                        76. 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()))
                                        78. 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|5.0.0
                                        (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()))
                                        80. 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()))
                                        82. 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()))
                                        84. 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()))
                                        86. 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()))
                                        88. 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.

                                        ShortLKF: Tageskomponente/KontaktpunkteProduct or service provided
                                        Control10..1*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Obligations
                                          ObligationsActor
                                          SHALL:populateMoped KH Actor
                                          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()))
                                          90. 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())
                                          92. 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()))
                                          94. 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()))
                                          96. 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()))
                                          98. 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()))
                                          100. 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()))
                                          102. 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.

                                          ShortLKF: Punkte Belagsdauerausreißer nach unten – LeistungskomponenteProduct or service provided
                                          Control0..1*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Obligations
                                            ObligationsActor
                                            SHALL:populateMoped KH Actor
                                            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()))
                                            104. 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())
                                            106. 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()))
                                            108. 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()))
                                            110. 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()))
                                            112. 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()))
                                            114. 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()))
                                            116. 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.

                                            ShortLKF: Punkte Belagsdauerausreißer nach unten – TageskomponenteProduct or service provided
                                            Control0..1*
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Obligations
                                              ObligationsActor
                                              SHALL:populateMoped KH Actor
                                              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()))
                                              118. 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())
                                              120. 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()))
                                              122. 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()))
                                              124. 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()))
                                              126. 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()))
                                              128. 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()))
                                              130. 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.

                                              ShortLKF: Zusatzpunkte Belagsdauerausreißer nach obenProduct or service provided
                                              Control0..1*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Obligations
                                                ObligationsActor
                                                SHALL:populateMoped KH Actor
                                                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()))
                                                132. 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())
                                                134. 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()))
                                                136. 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()))
                                                138. 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()))
                                                140. 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()))
                                                142. 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()))
                                                144. 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.

                                                ShortLKF: Zusatzpunkte IntensivProduct or service provided
                                                Control0..1*
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:populateMoped KH Actor
                                                  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()))
                                                  146. 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())
                                                  148. 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()))
                                                  150. 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()))
                                                  152. 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()))
                                                  154. 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()))
                                                  156. 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()))
                                                  158. 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.

                                                  ShortLKF: Zusatzpunkte MehrfachleistungenProduct or service provided
                                                  Control0..1*
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:populateMoped KH Actor
                                                    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()))
                                                    160. 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())
                                                    162. 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()))
                                                    164. 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()))
                                                    166. 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()))
                                                    168. 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()))
                                                    170. 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()))
                                                    172. 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.

                                                    ShortLKF: Punkte spezieller Bereiche (tageweise)Product or service provided
                                                    Control0..1*
                                                    TypeBackboneElement
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:populateMoped KH Actor
                                                      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()))
                                                      174. 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())
                                                      176. 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()))
                                                      178. 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()))
                                                      180. 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()))
                                                      182. 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()))
                                                      184. 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()))
                                                      186. 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.

                                                      ShortLKF: Punkte totalProduct or service provided
                                                      Control10..1*
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Obligations
                                                        ObligationsActor
                                                        SHALL:populateMoped KH Actor
                                                        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()))
                                                        188. 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())
                                                        190. 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()))
                                                        192. 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()))
                                                        194. 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()))
                                                        196. 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()))
                                                        198. 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
                                                        Control2..?
                                                        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
                                                          ShortLKF: Abrechnung – Knoten
                                                          Control1..1
                                                          TypeExtension(Abrechnung - Knoten) (Extension Type: Coding)
                                                          Obligations
                                                            ObligationsActor
                                                            SHALL:populateMoped KH Actor
                                                            6. Claim.extension:FehlerWarnung
                                                            Slice NameFehlerWarnung
                                                            Control0..*
                                                            TypeExtension(Error/Warning) (Complex Extension)
                                                            Obligations
                                                              ObligationsActor
                                                              SHALL:populateMoped KH Actor
                                                              8. Claim.extension:Fondsrelevanz
                                                              Slice NameFondsrelevanz
                                                              Control1..1
                                                              TypeExtension(Fondsrelevanz) (Extension Type: Coding)
                                                              Obligations
                                                                ObligationsActor
                                                                SHALL:populateMoped KH Actor
                                                                10. Claim.status
                                                                Obligations
                                                                  ObligationsActor
                                                                  SHALL:populateMoped KH Actor
                                                                  SHALL:handleMoped Device Actor
                                                                  12. Claim.type
                                                                  Obligations
                                                                    ObligationsActor
                                                                    SHALL:populateMoped KH Actor
                                                                    Pattern Value{
                                                                      "coding" : [{
                                                                        "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
                                                                        "code" : "institutional"
                                                                      }]
                                                                    }
                                                                    14. Claim.use
                                                                    Obligations
                                                                      ObligationsActor
                                                                      SHALL:populateMoped KH Actor
                                                                      Pattern Valueclaim
                                                                      16. Claim.patient
                                                                      TypeReference(HL7® AT Core Patient Profile)
                                                                      Obligations
                                                                        ObligationsActor
                                                                        SHALL:handleMoped Device Actor
                                                                        18. Claim.insurer
                                                                        Control1..?
                                                                        TypeReference(SV Organization)
                                                                        Obligations
                                                                          ObligationsActor
                                                                          SHALL:handleMoped Device Actor
                                                                          20. Claim.provider
                                                                          Control1..?
                                                                          TypeReference(KH Organization)
                                                                          Obligations
                                                                            ObligationsActor
                                                                            SHALL:handleMoped Device Actor
                                                                            22. Claim.related
                                                                            24. Claim.related.claim
                                                                            Control1..?
                                                                            TypeReference(MOPED LKFRequest)
                                                                            Obligations
                                                                              ObligationsActor
                                                                              SHALL:populateMoped KH Actor
                                                                              26. 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()
                                                                              • 28. Claim.encounter:MopedEncounter
                                                                                Slice NameMopedEncounter
                                                                                ShortGenerelle Informationen zu Aufnahme und Entlassung des Patienten
                                                                                Control1..1
                                                                                TypeReference(MOPED Encounter)
                                                                                Obligations
                                                                                  ObligationsActor
                                                                                  SHALL:handleMoped Device Actor
                                                                                  30. Claim.encounter:TransferEncounter
                                                                                  Slice NameTransferEncounter
                                                                                  ShortInformationen zu Verlegungen innerhalb oder zwischen Krankenanstalten
                                                                                  Control1..*
                                                                                  TypeReference(MOPED TransferEncounter)
                                                                                  Obligations
                                                                                    ObligationsActor
                                                                                    SHALL:handleMoped Device Actor
                                                                                    32. Claim.diagnosisRelatedGroup
                                                                                    ShortLKF: Abrechnung - Gruppe
                                                                                    Control1..?
                                                                                    BindingThe codes SHALL be taken from LKF Abrechnungsgruppe
                                                                                    (required to https://elga.moped.at/ValueSet/LKFAbrechnungsGruppeVS)
                                                                                    Obligations
                                                                                      ObligationsActor
                                                                                      SHALL:populateMoped KH Actor
                                                                                      34. Claim.supportingInfo
                                                                                      Control2..?
                                                                                      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
                                                                                      • 36. Claim.supportingInfo:Plausibilitaetskennzeichen
                                                                                        Slice NamePlausibilitaetskennzeichen
                                                                                        ShortPlausibilitätskennzeichen - Dieses Datenfeld enthält eine Kennzeichnung als Ergebnis der vom Gesundheitsministerium vorgegebenen Plausibilitätsprüfung.
                                                                                        Control1..1
                                                                                        Obligations
                                                                                          ObligationsActor
                                                                                          SHALL:populateMoped KH Actor
                                                                                          38. Claim.supportingInfo:Plausibilitaetskennzeichen.category
                                                                                          Pattern Value{
                                                                                            "coding" : [{
                                                                                              "system" : "https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS",
                                                                                              "code" : "PLAUS"
                                                                                            }]
                                                                                          }
                                                                                          40. 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
                                                                                          42. Claim.supportingInfo:EndgueltigeMeldung
                                                                                          Slice NameEndgueltigeMeldung
                                                                                          ShortFeld, welches angibt, ob es sich um die vorläufige oder endgültige Meldung handelt.
                                                                                          Control1..1
                                                                                          Obligations
                                                                                            ObligationsActor
                                                                                            SHALL:populateMoped KH Actor
                                                                                            44. Claim.supportingInfo:EndgueltigeMeldung.category
                                                                                            Pattern Value{
                                                                                              "coding" : [{
                                                                                                "system" : "https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS",
                                                                                                "code" : "ENDG"
                                                                                              }]
                                                                                            }
                                                                                            46. Claim.supportingInfo:EndgueltigeMeldung.value[x]
                                                                                            Typeboolean
                                                                                            [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
                                                                                            48. Claim.diagnosis
                                                                                            50. Claim.diagnosis.diagnosis[x]
                                                                                            TypeReference(MOPED Condition), CodeableConcept
                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                            Obligations
                                                                                              ObligationsActor
                                                                                              SHALL:populateMoped KH Actor
                                                                                              52. Claim.diagnosis.onAdmission
                                                                                              Definition

                                                                                              LKF: Diagnose – im stationären Aufenthalt erworben; Gibt an ob die Diagnose bereits bei Aufnahme in den stationären Aufenthalt vorhanden war

                                                                                              Obligations
                                                                                                ObligationsActor
                                                                                                SHALL:populateMoped KH Actor
                                                                                                54. Claim.procedure
                                                                                                56. Claim.procedure.extension
                                                                                                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
                                                                                                • 58. Claim.procedure.extension:AbrechnungsRelevanz
                                                                                                  Slice NameAbrechnungsRelevanz
                                                                                                  Control0..1
                                                                                                  TypeExtension(Medizinische Leistung - Abrechnungsrelevanz) (Extension Type: Coding)
                                                                                                  Obligations
                                                                                                    ObligationsActor
                                                                                                    SHALL:populateMoped KH Actor
                                                                                                    60. Claim.procedure.procedure[x]
                                                                                                    TypeReference(MOPED Procedure), CodeableConcept
                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                    Obligations
                                                                                                      ObligationsActor
                                                                                                      SHALL:populateMoped KH Actor
                                                                                                      62. Claim.insurance
                                                                                                      64. Claim.insurance.coverage
                                                                                                      TypeReference(MOPED Coverage)
                                                                                                      Obligations
                                                                                                        ObligationsActor
                                                                                                        SHALL:handleMoped Device Actor
                                                                                                        66. 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
                                                                                                        • 68. Claim.item:Leistungskomponente
                                                                                                          Slice NameLeistungskomponente
                                                                                                          ShortLKF: Leistungskomponente/Leistungspunkte
                                                                                                          Control1..1
                                                                                                          Obligations
                                                                                                            ObligationsActor
                                                                                                            SHALL:populateMoped KH Actor
                                                                                                            70. Claim.item:Leistungskomponente.category
                                                                                                            BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                                                                                            (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                                                                                            72. Claim.item:Leistungskomponente.category.coding
                                                                                                            Control1..?
                                                                                                            Pattern Value{
                                                                                                              "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                                                                                              "code" : "LDFPLK"
                                                                                                            }
                                                                                                            74. Claim.item:Leistungskomponente.quantity
                                                                                                            ShortPunkteanzahl
                                                                                                            Control1..?
                                                                                                            76. Claim.item:Leistungskomponente.quantity.unit
                                                                                                            Pattern ValueLKF Punkte
                                                                                                            78. Claim.item:Tageskomponente
                                                                                                            Slice NameTageskomponente
                                                                                                            ShortLKF: Tageskomponente/Kontaktpunkte
                                                                                                            Control1..1
                                                                                                            Obligations
                                                                                                              ObligationsActor
                                                                                                              SHALL:populateMoped KH Actor
                                                                                                              80. Claim.item:Tageskomponente.category
                                                                                                              82. 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"
                                                                                                              }
                                                                                                              84. Claim.item:Tageskomponente.quantity
                                                                                                              ShortPunkteanzahl
                                                                                                              Control1..?
                                                                                                              86. Claim.item:Tageskomponente.quantity.value
                                                                                                              Control1..?
                                                                                                              88. Claim.item:Tageskomponente.quantity.unit
                                                                                                              Pattern ValueLKF Punkte
                                                                                                              90. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente
                                                                                                              Slice NamePunkteBelagsdauerausreisserUntenLeistungskomponente
                                                                                                              ShortLKF: Punkte Belagsdauerausreißer nach unten – Leistungskomponente
                                                                                                              Control0..1
                                                                                                              Obligations
                                                                                                                ObligationsActor
                                                                                                                SHALL:populateMoped KH Actor
                                                                                                                92. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.category
                                                                                                                94. 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"
                                                                                                                }
                                                                                                                96. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity
                                                                                                                ShortPunkteanzahl
                                                                                                                Control1..?
                                                                                                                98. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.value
                                                                                                                Control1..?
                                                                                                                100. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.unit
                                                                                                                Pattern ValueLKF Punkte
                                                                                                                102. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente
                                                                                                                Slice NamePunkteBelagsdauerausreisserUntenTageskomponente
                                                                                                                ShortLKF: Punkte Belagsdauerausreißer nach unten – Tageskomponente
                                                                                                                Control0..1
                                                                                                                Obligations
                                                                                                                  ObligationsActor
                                                                                                                  SHALL:populateMoped KH Actor
                                                                                                                  104. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.category
                                                                                                                  106. 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"
                                                                                                                  }
                                                                                                                  108. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity
                                                                                                                  ShortPunkteanzahl
                                                                                                                  Control1..?
                                                                                                                  110. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.value
                                                                                                                  Control1..?
                                                                                                                  112. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.unit
                                                                                                                  Pattern ValueLKF Punkte
                                                                                                                  114. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben
                                                                                                                  Slice NameZusatzpunkteBelagsdauerausreisserNachOben
                                                                                                                  ShortLKF: Zusatzpunkte Belagsdauerausreißer nach oben
                                                                                                                  Control0..1
                                                                                                                  Obligations
                                                                                                                    ObligationsActor
                                                                                                                    SHALL:populateMoped KH Actor
                                                                                                                    116. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.category
                                                                                                                    118. 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"
                                                                                                                    }
                                                                                                                    120. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity
                                                                                                                    ShortPunkteanzahl
                                                                                                                    Control1..?
                                                                                                                    122. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.value
                                                                                                                    Control1..?
                                                                                                                    124. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.unit
                                                                                                                    Pattern ValueLKF Punkte
                                                                                                                    126. Claim.item:ZusatzpunkteIntensiv
                                                                                                                    Slice NameZusatzpunkteIntensiv
                                                                                                                    ShortLKF: Zusatzpunkte Intensiv
                                                                                                                    Control0..1
                                                                                                                    Obligations
                                                                                                                      ObligationsActor
                                                                                                                      SHALL:populateMoped KH Actor
                                                                                                                      128. Claim.item:ZusatzpunkteIntensiv.category
                                                                                                                      130. 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"
                                                                                                                      }
                                                                                                                      132. Claim.item:ZusatzpunkteIntensiv.quantity
                                                                                                                      ShortPunkteanzahl
                                                                                                                      Control1..?
                                                                                                                      134. Claim.item:ZusatzpunkteIntensiv.quantity.value
                                                                                                                      Control1..?
                                                                                                                      136. Claim.item:ZusatzpunkteIntensiv.quantity.unit
                                                                                                                      Pattern ValueLKF Punkte
                                                                                                                      138. Claim.item:ZusatzpunkteMehrfachleistungen
                                                                                                                      Slice NameZusatzpunkteMehrfachleistungen
                                                                                                                      ShortLKF: Zusatzpunkte Mehrfachleistungen
                                                                                                                      Control0..1
                                                                                                                      Obligations
                                                                                                                        ObligationsActor
                                                                                                                        SHALL:populateMoped KH Actor
                                                                                                                        140. Claim.item:ZusatzpunkteMehrfachleistungen.category
                                                                                                                        142. 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"
                                                                                                                        }
                                                                                                                        144. Claim.item:ZusatzpunkteMehrfachleistungen.quantity
                                                                                                                        ShortPunkteanzahl
                                                                                                                        Control1..?
                                                                                                                        146. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.value
                                                                                                                        Control1..?
                                                                                                                        148. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.unit
                                                                                                                        Pattern ValueLKF Punkte
                                                                                                                        150. Claim.item:PunkteSpeziellerBereicheTageweise
                                                                                                                        Slice NamePunkteSpeziellerBereicheTageweise
                                                                                                                        ShortLKF: Punkte spezieller Bereiche (tageweise)
                                                                                                                        Control0..1
                                                                                                                        Obligations
                                                                                                                          ObligationsActor
                                                                                                                          SHALL:populateMoped KH Actor
                                                                                                                          152. Claim.item:PunkteSpeziellerBereicheTageweise.category
                                                                                                                          154. 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"
                                                                                                                          }
                                                                                                                          156. Claim.item:PunkteSpeziellerBereicheTageweise.quantity
                                                                                                                          ShortPunkteanzahl
                                                                                                                          Control1..?
                                                                                                                          158. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.value
                                                                                                                          Control1..?
                                                                                                                          160. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.unit
                                                                                                                          Pattern ValueLKF Punkte
                                                                                                                          162. Claim.item:Gesamtpunkte
                                                                                                                          Slice NameGesamtpunkte
                                                                                                                          ShortLKF: Punkte total
                                                                                                                          Control1..1
                                                                                                                          Obligations
                                                                                                                            ObligationsActor
                                                                                                                            SHALL:populateMoped KH Actor
                                                                                                                            164. Claim.item:Gesamtpunkte.category
                                                                                                                            166. 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"
                                                                                                                            }
                                                                                                                            168. Claim.item:Gesamtpunkte.quantity
                                                                                                                            ShortPunkteanzahl
                                                                                                                            Control1..?
                                                                                                                            170. Claim.item:Gesamtpunkte.quantity.value
                                                                                                                            Control1..?
                                                                                                                            172. 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
                                                                                                                            Control2..*
                                                                                                                            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.

                                                                                                                              ShortLKF: Abrechnung – Knoten
                                                                                                                              Control1..1
                                                                                                                              TypeExtension(Abrechnung - Knoten) (Extension Type: Coding)
                                                                                                                              Is Modifierfalse
                                                                                                                              Must Supportfalse
                                                                                                                              Obligations
                                                                                                                                ObligationsActor
                                                                                                                                SHALL:populateMoped KH Actor
                                                                                                                                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
                                                                                                                                Obligations
                                                                                                                                  ObligationsActor
                                                                                                                                  SHALL:populateMoped KH Actor
                                                                                                                                  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.extension:Fondsrelevanz
                                                                                                                                  Slice NameFondsrelevanz
                                                                                                                                  Definition

                                                                                                                                  Hier ist anzugeben, ob der stationäre Aufenthalt/ambulante Besuch gegenüber dem Landesgesundheitsfonds/PRIKRAF abzurechnen ist.

                                                                                                                                  ShortFondsrelevanz
                                                                                                                                  Control1..1
                                                                                                                                  TypeExtension(Fondsrelevanz) (Extension Type: Coding)
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Must Supportfalse
                                                                                                                                  Obligations
                                                                                                                                    ObligationsActor
                                                                                                                                    SHALL:populateMoped KH Actor
                                                                                                                                    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())
                                                                                                                                    22. 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())
                                                                                                                                    24. 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()))
                                                                                                                                    26. 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()))
                                                                                                                                    28. 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
                                                                                                                                    Obligations
                                                                                                                                      ObligationsActor
                                                                                                                                      SHALL:populateMoped KH Actor
                                                                                                                                      SHALL:handleMoped Device Actor
                                                                                                                                      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()))
                                                                                                                                      30. 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|5.0.0)

                                                                                                                                      The type or discipline-style of the claim.

                                                                                                                                      TypeCodeableConcept
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Must Supportfalse
                                                                                                                                      Obligations
                                                                                                                                        ObligationsActor
                                                                                                                                        SHALL:populateMoped KH Actor
                                                                                                                                        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()))
                                                                                                                                        32. 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|5.0.0)

                                                                                                                                        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()))
                                                                                                                                        34. 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
                                                                                                                                        Obligations
                                                                                                                                          ObligationsActor
                                                                                                                                          SHALL:populateMoped KH Actor
                                                                                                                                          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()))
                                                                                                                                          36. 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
                                                                                                                                          Obligations
                                                                                                                                            ObligationsActor
                                                                                                                                            SHALL:handleMoped Device Actor
                                                                                                                                            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()))
                                                                                                                                            38. 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()))
                                                                                                                                            40. 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()))
                                                                                                                                            42. 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()))
                                                                                                                                            44. Claim.insurer
                                                                                                                                            Definition

                                                                                                                                            The Insurer who is target of the request.

                                                                                                                                            ShortTarget
                                                                                                                                            Control1..1
                                                                                                                                            TypeReference(SV Organization)
                                                                                                                                            Is Modifierfalse
                                                                                                                                            Must Supportfalse
                                                                                                                                            Obligations
                                                                                                                                              ObligationsActor
                                                                                                                                              SHALL:handleMoped Device Actor
                                                                                                                                              Summarytrue
                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              46. 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
                                                                                                                                              Obligations
                                                                                                                                                ObligationsActor
                                                                                                                                                SHALL:handleMoped Device Actor
                                                                                                                                                Summarytrue
                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                48. 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|5.0.0)

                                                                                                                                                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()))
                                                                                                                                                50. 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|5.0.0)

                                                                                                                                                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()))
                                                                                                                                                52. 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()))
                                                                                                                                                54. 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
                                                                                                                                                56. 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())
                                                                                                                                                58. 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())
                                                                                                                                                60. Claim.related.claim
                                                                                                                                                Definition

                                                                                                                                                Reference to a related claim.

                                                                                                                                                ShortReference to the related claim
                                                                                                                                                Control1..1
                                                                                                                                                TypeReference(MOPED LKFRequest)
                                                                                                                                                Is Modifierfalse
                                                                                                                                                Must Supportfalse
                                                                                                                                                Obligations
                                                                                                                                                  ObligationsActor
                                                                                                                                                  SHALL:populateMoped KH Actor
                                                                                                                                                  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()))
                                                                                                                                                  62. 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|5.0.0)

                                                                                                                                                  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()))
                                                                                                                                                  64. 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()))
                                                                                                                                                  66. 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()))
                                                                                                                                                  68. 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()))
                                                                                                                                                  70. 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()))
                                                                                                                                                  72. 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
                                                                                                                                                  74. 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())
                                                                                                                                                  76. 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())
                                                                                                                                                  78. 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|5.0.0)

                                                                                                                                                  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()))
                                                                                                                                                  80. 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()))
                                                                                                                                                  82. 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()))
                                                                                                                                                  84. 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()
                                                                                                                                                  • 86. 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
                                                                                                                                                    Obligations
                                                                                                                                                      ObligationsActor
                                                                                                                                                      SHALL:handleMoped Device Actor
                                                                                                                                                      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.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
                                                                                                                                                      Obligations
                                                                                                                                                        ObligationsActor
                                                                                                                                                        SHALL:handleMoped Device Actor
                                                                                                                                                        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()))
                                                                                                                                                        90. 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()))
                                                                                                                                                        92. 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.

                                                                                                                                                        ShortLKF: Abrechnung - Gruppe
                                                                                                                                                        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
                                                                                                                                                        Obligations
                                                                                                                                                          ObligationsActor
                                                                                                                                                          SHALL:populateMoped KH Actor
                                                                                                                                                          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()))
                                                                                                                                                          94. 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()))
                                                                                                                                                          96. 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
                                                                                                                                                          98. 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())
                                                                                                                                                          100. 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())
                                                                                                                                                          102. 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|5.0.0)
                                                                                                                                                          TypeCodeableConcept
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Must Supportfalse
                                                                                                                                                          Summaryfalse
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          104. 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()))
                                                                                                                                                          106. 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()))
                                                                                                                                                          108. 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
                                                                                                                                                          110. 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())
                                                                                                                                                          112. 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())
                                                                                                                                                          114. 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()))
                                                                                                                                                          116. 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()))
                                                                                                                                                          118. 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()))
                                                                                                                                                          120. 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|5.0.0)

                                                                                                                                                          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()))
                                                                                                                                                          122. 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|5.0.0)
                                                                                                                                                          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()))
                                                                                                                                                          124. 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.

                                                                                                                                                          Control2..*
                                                                                                                                                          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
                                                                                                                                                          • 126. 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
                                                                                                                                                            128. 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())
                                                                                                                                                            130. 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())
                                                                                                                                                            132. 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()))
                                                                                                                                                            134. 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|5.0.0)

                                                                                                                                                            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()))
                                                                                                                                                            136. 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|5.0.0)

                                                                                                                                                            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()))
                                                                                                                                                            138. 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()))
                                                                                                                                                            140. 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()))
                                                                                                                                                            142. 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|5.0.0)

                                                                                                                                                            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()))
                                                                                                                                                            144. 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
                                                                                                                                                            Obligations
                                                                                                                                                              ObligationsActor
                                                                                                                                                              SHALL:populateMoped KH Actor
                                                                                                                                                              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()))
                                                                                                                                                              146. 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
                                                                                                                                                              148. 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())
                                                                                                                                                              150. 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())
                                                                                                                                                              152. 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()))
                                                                                                                                                              154. 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|5.0.0)

                                                                                                                                                              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()))
                                                                                                                                                              156. 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|5.0.0)

                                                                                                                                                              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()))
                                                                                                                                                              158. 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()))
                                                                                                                                                              160. 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()))
                                                                                                                                                              162. 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|5.0.0)

                                                                                                                                                              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()))
                                                                                                                                                              164. Claim.supportingInfo:EndgueltigeMeldung
                                                                                                                                                              Slice NameEndgueltigeMeldung
                                                                                                                                                              Definition

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

                                                                                                                                                              ShortFeld, welches angibt, ob es sich um die vorläufige oder endgültige Meldung handelt.
                                                                                                                                                              Comments

                                                                                                                                                              Often there are multiple jurisdiction specific valuesets which are required.

                                                                                                                                                              Control1..1
                                                                                                                                                              TypeBackboneElement
                                                                                                                                                              Is Modifierfalse
                                                                                                                                                              Must Supportfalse
                                                                                                                                                              Obligations
                                                                                                                                                                ObligationsActor
                                                                                                                                                                SHALL:populateMoped KH Actor
                                                                                                                                                                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()))
                                                                                                                                                                166. Claim.supportingInfo:EndgueltigeMeldung.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
                                                                                                                                                                168. Claim.supportingInfo:EndgueltigeMeldung.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())
                                                                                                                                                                170. Claim.supportingInfo:EndgueltigeMeldung.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.supportingInfo:EndgueltigeMeldung.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()))
                                                                                                                                                                174. Claim.supportingInfo:EndgueltigeMeldung.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|5.0.0)

                                                                                                                                                                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" : "ENDG"
                                                                                                                                                                  }]
                                                                                                                                                                }
                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                176. Claim.supportingInfo:EndgueltigeMeldung.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|5.0.0)

                                                                                                                                                                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()))
                                                                                                                                                                178. Claim.supportingInfo:EndgueltigeMeldung.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()))
                                                                                                                                                                180. Claim.supportingInfo:EndgueltigeMeldung.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
                                                                                                                                                                Typeboolean
                                                                                                                                                                [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()))
                                                                                                                                                                182. Claim.supportingInfo:EndgueltigeMeldung.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|5.0.0)

                                                                                                                                                                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()))
                                                                                                                                                                184. Claim.diagnosis
                                                                                                                                                                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()))
                                                                                                                                                                186. 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
                                                                                                                                                                188. 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())
                                                                                                                                                                190. 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())
                                                                                                                                                                192. 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()))
                                                                                                                                                                194. 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
                                                                                                                                                                TypeReference(MOPED Condition)
                                                                                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                Must Supportfalse
                                                                                                                                                                Obligations
                                                                                                                                                                  ObligationsActor
                                                                                                                                                                  SHALL:populateMoped KH Actor
                                                                                                                                                                  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()))
                                                                                                                                                                  196. 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|5.0.0)

                                                                                                                                                                  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()))
                                                                                                                                                                  198. Claim.diagnosis.onAdmission
                                                                                                                                                                  Definition

                                                                                                                                                                  LKF: Diagnose – im stationären Aufenthalt erworben; 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|5.0.0)

                                                                                                                                                                  Present on admission.

                                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                  Must Supportfalse
                                                                                                                                                                  Obligations
                                                                                                                                                                    ObligationsActor
                                                                                                                                                                    SHALL:populateMoped KH Actor
                                                                                                                                                                    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()))
                                                                                                                                                                    200. 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()))
                                                                                                                                                                    202. 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
                                                                                                                                                                    204. Claim.procedure.extension
                                                                                                                                                                    Definition

                                                                                                                                                                    An Extension

                                                                                                                                                                    ShortExtension
                                                                                                                                                                    Control0..*
                                                                                                                                                                    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
                                                                                                                                                                    • 206. 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
                                                                                                                                                                      Control0..1
                                                                                                                                                                      TypeExtension(Medizinische Leistung - Abrechnungsrelevanz) (Extension Type: Coding)
                                                                                                                                                                      Is Modifierfalse
                                                                                                                                                                      Obligations
                                                                                                                                                                        ObligationsActor
                                                                                                                                                                        SHALL:populateMoped KH Actor
                                                                                                                                                                        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())
                                                                                                                                                                        208. 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())
                                                                                                                                                                        210. 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()))
                                                                                                                                                                        212. 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|5.0.0)

                                                                                                                                                                        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()))
                                                                                                                                                                        214. 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()))
                                                                                                                                                                        216. Claim.procedure.procedure[x]
                                                                                                                                                                        Definition

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

                                                                                                                                                                        ShortSpecific clinical procedure
                                                                                                                                                                        Control1..1
                                                                                                                                                                        TypeReference(MOPED Procedure)
                                                                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                        Must Supportfalse
                                                                                                                                                                        Obligations
                                                                                                                                                                          ObligationsActor
                                                                                                                                                                          SHALL:populateMoped KH Actor
                                                                                                                                                                          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()))
                                                                                                                                                                          218. 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()))
                                                                                                                                                                          220. 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()))
                                                                                                                                                                          222. 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
                                                                                                                                                                          224. 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())
                                                                                                                                                                          226. 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())
                                                                                                                                                                          228. 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()))
                                                                                                                                                                          230. 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()))
                                                                                                                                                                          232. 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()))
                                                                                                                                                                          234. 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
                                                                                                                                                                          Obligations
                                                                                                                                                                            ObligationsActor
                                                                                                                                                                            SHALL:handleMoped Device Actor
                                                                                                                                                                            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()))
                                                                                                                                                                            236. 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()))
                                                                                                                                                                            238. 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()))
                                                                                                                                                                            240. 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()))
                                                                                                                                                                            242. 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()))
                                                                                                                                                                            244. 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
                                                                                                                                                                            246. 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())
                                                                                                                                                                            248. 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())
                                                                                                                                                                            250. 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()))
                                                                                                                                                                            252. 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()))
                                                                                                                                                                            254. 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()))
                                                                                                                                                                            256. 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()))
                                                                                                                                                                            258. 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
                                                                                                                                                                            • 260. 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
                                                                                                                                                                              262. 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())
                                                                                                                                                                              264. 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())
                                                                                                                                                                              266. 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()))
                                                                                                                                                                              268. 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()))
                                                                                                                                                                              270. 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()))
                                                                                                                                                                              272. 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()))
                                                                                                                                                                              274. 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()))
                                                                                                                                                                              276. 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()))
                                                                                                                                                                              278. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              280. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              282. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              284. 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|5.0.0)
                                                                                                                                                                              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()))
                                                                                                                                                                              286. 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()))
                                                                                                                                                                              288. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              290. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              292. 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()))
                                                                                                                                                                              294. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              296. 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()))
                                                                                                                                                                              298. 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()))
                                                                                                                                                                              300. 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()))
                                                                                                                                                                              302. 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()))
                                                                                                                                                                              304. 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()))
                                                                                                                                                                              306. 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()))
                                                                                                                                                                              308. 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()))
                                                                                                                                                                              310. 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()))
                                                                                                                                                                              312. 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
                                                                                                                                                                              314. 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())
                                                                                                                                                                              316. 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())
                                                                                                                                                                              318. 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|5.0.0)
                                                                                                                                                                              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()))
                                                                                                                                                                              320. 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|5.0.0)
                                                                                                                                                                              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()))
                                                                                                                                                                              322. 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()))
                                                                                                                                                                              324. 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()))
                                                                                                                                                                              326. 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
                                                                                                                                                                              328. 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())
                                                                                                                                                                              330. 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())
                                                                                                                                                                              332. 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()))
                                                                                                                                                                              334. 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()))
                                                                                                                                                                              336. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              338. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              340. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              342. 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|5.0.0)
                                                                                                                                                                              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()))
                                                                                                                                                                              344. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              346. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              348. 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()))
                                                                                                                                                                              350. 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()))
                                                                                                                                                                              352. 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()))
                                                                                                                                                                              354. 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()))
                                                                                                                                                                              356. 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()))
                                                                                                                                                                              358. 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()))
                                                                                                                                                                              360. 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()))
                                                                                                                                                                              362. 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()))
                                                                                                                                                                              364. 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
                                                                                                                                                                              366. 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())
                                                                                                                                                                              368. 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())
                                                                                                                                                                              370. 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()))
                                                                                                                                                                              372. 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()))
                                                                                                                                                                              374. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              376. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              378. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              380. 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|5.0.0)
                                                                                                                                                                              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()))
                                                                                                                                                                              382. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              384. 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|5.0.0)

                                                                                                                                                                              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()))
                                                                                                                                                                              386. 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()))
                                                                                                                                                                              388. 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()))
                                                                                                                                                                              390. 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()))
                                                                                                                                                                              392. 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()))
                                                                                                                                                                              394. 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()))
                                                                                                                                                                              396. 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()))
                                                                                                                                                                              398. 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()))
                                                                                                                                                                              400. 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.

                                                                                                                                                                              ShortLKF: Leistungskomponente/Leistungspunkte
                                                                                                                                                                              Control1..1
                                                                                                                                                                              TypeBackboneElement
                                                                                                                                                                              Is Modifierfalse
                                                                                                                                                                              Must Supportfalse
                                                                                                                                                                              Obligations
                                                                                                                                                                                ObligationsActor
                                                                                                                                                                                SHALL:populateMoped KH Actor
                                                                                                                                                                                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()))
                                                                                                                                                                                402. 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
                                                                                                                                                                                404. 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())
                                                                                                                                                                                406. 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())
                                                                                                                                                                                408. 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()))
                                                                                                                                                                                410. 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()))
                                                                                                                                                                                412. 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()))
                                                                                                                                                                                414. 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()))
                                                                                                                                                                                416. 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()))
                                                                                                                                                                                418. 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()))
                                                                                                                                                                                420. 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|5.0.0)

                                                                                                                                                                                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()))
                                                                                                                                                                                422. 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()))
                                                                                                                                                                                424. 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
                                                                                                                                                                                426. 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
                                                                                                                                                                                • 428. 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()))
                                                                                                                                                                                  430. 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()))
                                                                                                                                                                                  432. 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|5.0.0)

                                                                                                                                                                                  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()))
                                                                                                                                                                                  434. 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|5.0.0)
                                                                                                                                                                                  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()))
                                                                                                                                                                                  436. 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()))
                                                                                                                                                                                  438. 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|5.0.0)

                                                                                                                                                                                  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()))
                                                                                                                                                                                  440. 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|5.0.0)

                                                                                                                                                                                  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()))
                                                                                                                                                                                  442. 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()))
                                                                                                                                                                                  444. 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|5.0.0)

                                                                                                                                                                                  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()))
                                                                                                                                                                                  446. 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()))
                                                                                                                                                                                  448. 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()))
                                                                                                                                                                                  450. 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
                                                                                                                                                                                  452. 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
                                                                                                                                                                                  • 454. 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()))
                                                                                                                                                                                    456. 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()))
                                                                                                                                                                                    458. 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()))
                                                                                                                                                                                    460. 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()))
                                                                                                                                                                                    462. 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()))
                                                                                                                                                                                    464. 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()))
                                                                                                                                                                                    466. 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()))
                                                                                                                                                                                    468. 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()))
                                                                                                                                                                                    470. 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()))
                                                                                                                                                                                    472. 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()))
                                                                                                                                                                                    474. 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()))
                                                                                                                                                                                    476. 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
                                                                                                                                                                                    478. 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())
                                                                                                                                                                                    480. 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())
                                                                                                                                                                                    482. 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|5.0.0)
                                                                                                                                                                                    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()))
                                                                                                                                                                                    484. 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|5.0.0)
                                                                                                                                                                                    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()))
                                                                                                                                                                                    486. 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()))
                                                                                                                                                                                    488. 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()))
                                                                                                                                                                                    490. 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
                                                                                                                                                                                    492. 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())
                                                                                                                                                                                    494. 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())
                                                                                                                                                                                    496. 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()))
                                                                                                                                                                                    498. 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()))
                                                                                                                                                                                    500. 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|5.0.0)

                                                                                                                                                                                    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()))
                                                                                                                                                                                    502. 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|5.0.0)

                                                                                                                                                                                    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()))
                                                                                                                                                                                    504. 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|5.0.0)

                                                                                                                                                                                    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()))
                                                                                                                                                                                    506. 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|5.0.0)
                                                                                                                                                                                    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()))
                                                                                                                                                                                    508. 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|5.0.0)

                                                                                                                                                                                    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()))
                                                                                                                                                                                    510. 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|5.0.0)

                                                                                                                                                                                    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()))
                                                                                                                                                                                    512. 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()))
                                                                                                                                                                                    514. 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()))
                                                                                                                                                                                    516. 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()))
                                                                                                                                                                                    518. 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()))
                                                                                                                                                                                    520. 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()))
                                                                                                                                                                                    522. 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()))
                                                                                                                                                                                    524. 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()))
                                                                                                                                                                                    526. 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()))
                                                                                                                                                                                    528. 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
                                                                                                                                                                                    530. 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())
                                                                                                                                                                                    532. 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())
                                                                                                                                                                                    534. 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()))
                                                                                                                                                                                    536. 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()))
                                                                                                                                                                                    538. 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|5.0.0)

                                                                                                                                                                                    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()))
                                                                                                                                                                                    540. 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|5.0.0)

                                                                                                                                                                                    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()))
                                                                                                                                                                                    542. 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|5.0.0)

                                                                                                                                                                                    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()))
                                                                                                                                                                                    544. 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|5.0.0)
                                                                                                                                                                                    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()))
                                                                                                                                                                                    546. 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|5.0.0)

                                                                                                                                                                                    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()))
                                                                                                                                                                                    548. 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|5.0.0)

                                                                                                                                                                                    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()))
                                                                                                                                                                                    550. 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()))
                                                                                                                                                                                    552. 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()))
                                                                                                                                                                                    554. 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()))
                                                                                                                                                                                    556. 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()))
                                                                                                                                                                                    558. 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()))
                                                                                                                                                                                    560. 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()))
                                                                                                                                                                                    562. 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()))
                                                                                                                                                                                    564. 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.

                                                                                                                                                                                    ShortLKF: Tageskomponente/Kontaktpunkte
                                                                                                                                                                                    Control1..1
                                                                                                                                                                                    TypeBackboneElement
                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                    Must Supportfalse
                                                                                                                                                                                    Obligations
                                                                                                                                                                                      ObligationsActor
                                                                                                                                                                                      SHALL:populateMoped KH Actor
                                                                                                                                                                                      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()))
                                                                                                                                                                                      566. 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
                                                                                                                                                                                      568. 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())
                                                                                                                                                                                      570. 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())
                                                                                                                                                                                      572. 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()))
                                                                                                                                                                                      574. 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()))
                                                                                                                                                                                      576. 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()))
                                                                                                                                                                                      578. 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()))
                                                                                                                                                                                      580. 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()))
                                                                                                                                                                                      582. 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()))
                                                                                                                                                                                      584. 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|5.0.0)

                                                                                                                                                                                      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()))
                                                                                                                                                                                      586. 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|5.0.0)

                                                                                                                                                                                      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()))
                                                                                                                                                                                      588. 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
                                                                                                                                                                                      590. 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
                                                                                                                                                                                      • 592. 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()))
                                                                                                                                                                                        594. 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()))
                                                                                                                                                                                        596. 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|5.0.0)

                                                                                                                                                                                        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()))
                                                                                                                                                                                        598. 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|5.0.0)
                                                                                                                                                                                        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()))
                                                                                                                                                                                        600. 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()))
                                                                                                                                                                                        602. 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|5.0.0)

                                                                                                                                                                                        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()))
                                                                                                                                                                                        604. 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|5.0.0)

                                                                                                                                                                                        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()))
                                                                                                                                                                                        606. 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()))
                                                                                                                                                                                        608. 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|5.0.0)

                                                                                                                                                                                        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()))
                                                                                                                                                                                        610. 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()))
                                                                                                                                                                                        612. 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()))
                                                                                                                                                                                        614. 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
                                                                                                                                                                                        616. 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
                                                                                                                                                                                        • 618. 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()))
                                                                                                                                                                                          620. 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()))
                                                                                                                                                                                          622. 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()))
                                                                                                                                                                                          624. 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()))
                                                                                                                                                                                          626. 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()))
                                                                                                                                                                                          628. 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()))
                                                                                                                                                                                          630. 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()))
                                                                                                                                                                                          632. 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()))
                                                                                                                                                                                          634. 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()))
                                                                                                                                                                                          636. 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()))
                                                                                                                                                                                          638. 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()))
                                                                                                                                                                                          640. 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
                                                                                                                                                                                          642. 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())
                                                                                                                                                                                          644. 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())
                                                                                                                                                                                          646. 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|5.0.0)
                                                                                                                                                                                          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()))
                                                                                                                                                                                          648. 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|5.0.0)
                                                                                                                                                                                          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()))
                                                                                                                                                                                          650. 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()))
                                                                                                                                                                                          652. 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()))
                                                                                                                                                                                          654. 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
                                                                                                                                                                                          656. 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())
                                                                                                                                                                                          658. 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())
                                                                                                                                                                                          660. 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()))
                                                                                                                                                                                          662. 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()))
                                                                                                                                                                                          664. 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|5.0.0)

                                                                                                                                                                                          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()))
                                                                                                                                                                                          666. 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|5.0.0)

                                                                                                                                                                                          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()))
                                                                                                                                                                                          668. 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|5.0.0)

                                                                                                                                                                                          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()))
                                                                                                                                                                                          670. 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|5.0.0)
                                                                                                                                                                                          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()))
                                                                                                                                                                                          672. 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|5.0.0)

                                                                                                                                                                                          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()))
                                                                                                                                                                                          674. 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|5.0.0)

                                                                                                                                                                                          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()))
                                                                                                                                                                                          676. 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()))
                                                                                                                                                                                          678. 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()))
                                                                                                                                                                                          680. 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()))
                                                                                                                                                                                          682. 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()))
                                                                                                                                                                                          684. 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()))
                                                                                                                                                                                          686. 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()))
                                                                                                                                                                                          688. 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()))
                                                                                                                                                                                          690. 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()))
                                                                                                                                                                                          692. 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
                                                                                                                                                                                          694. 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())
                                                                                                                                                                                          696. 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())
                                                                                                                                                                                          698. 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()))
                                                                                                                                                                                          700. 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()))
                                                                                                                                                                                          702. 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|5.0.0)

                                                                                                                                                                                          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()))
                                                                                                                                                                                          704. 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|5.0.0)

                                                                                                                                                                                          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()))
                                                                                                                                                                                          706. 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|5.0.0)

                                                                                                                                                                                          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()))
                                                                                                                                                                                          708. 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|5.0.0)
                                                                                                                                                                                          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()))
                                                                                                                                                                                          710. 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|5.0.0)

                                                                                                                                                                                          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()))
                                                                                                                                                                                          712. 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|5.0.0)

                                                                                                                                                                                          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()))
                                                                                                                                                                                          714. 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()))
                                                                                                                                                                                          716. 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()))
                                                                                                                                                                                          718. 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()))
                                                                                                                                                                                          720. 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()))
                                                                                                                                                                                          722. 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()))
                                                                                                                                                                                          724. 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()))
                                                                                                                                                                                          726. 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()))
                                                                                                                                                                                          728. 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.

                                                                                                                                                                                          ShortLKF: Punkte Belagsdauerausreißer nach unten – Leistungskomponente
                                                                                                                                                                                          Control0..1
                                                                                                                                                                                          TypeBackboneElement
                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                          Must Supportfalse
                                                                                                                                                                                          Obligations
                                                                                                                                                                                            ObligationsActor
                                                                                                                                                                                            SHALL:populateMoped KH Actor
                                                                                                                                                                                            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()))
                                                                                                                                                                                            730. 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
                                                                                                                                                                                            732. 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())
                                                                                                                                                                                            734. 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())
                                                                                                                                                                                            736. 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()))
                                                                                                                                                                                            738. 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()))
                                                                                                                                                                                            740. 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()))
                                                                                                                                                                                            742. 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()))
                                                                                                                                                                                            744. 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()))
                                                                                                                                                                                            746. 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()))
                                                                                                                                                                                            748. 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|5.0.0)

                                                                                                                                                                                            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()))
                                                                                                                                                                                            750. 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|5.0.0)

                                                                                                                                                                                            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()))
                                                                                                                                                                                            752. 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
                                                                                                                                                                                            754. 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
                                                                                                                                                                                            • 756. 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()))
                                                                                                                                                                                              758. 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()))
                                                                                                                                                                                              760. 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|5.0.0)

                                                                                                                                                                                              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()))
                                                                                                                                                                                              762. 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|5.0.0)
                                                                                                                                                                                              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()))
                                                                                                                                                                                              764. 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()))
                                                                                                                                                                                              766. 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|5.0.0)

                                                                                                                                                                                              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()))
                                                                                                                                                                                              768. 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|5.0.0)

                                                                                                                                                                                              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()))
                                                                                                                                                                                              770. 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()))
                                                                                                                                                                                              772. 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|5.0.0)

                                                                                                                                                                                              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()))
                                                                                                                                                                                              774. 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()))
                                                                                                                                                                                              776. 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()))
                                                                                                                                                                                              778. 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
                                                                                                                                                                                              780. 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
                                                                                                                                                                                              • 782. 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()))
                                                                                                                                                                                                784. 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()))
                                                                                                                                                                                                786. 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()))
                                                                                                                                                                                                788. 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()))
                                                                                                                                                                                                790. 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()))
                                                                                                                                                                                                792. 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()))
                                                                                                                                                                                                794. 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()))
                                                                                                                                                                                                796. 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()))
                                                                                                                                                                                                798. 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()))
                                                                                                                                                                                                800. 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()))
                                                                                                                                                                                                802. 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()))
                                                                                                                                                                                                804. 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
                                                                                                                                                                                                806. 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())
                                                                                                                                                                                                808. 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())
                                                                                                                                                                                                810. 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|5.0.0)
                                                                                                                                                                                                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()))
                                                                                                                                                                                                812. 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|5.0.0)
                                                                                                                                                                                                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()))
                                                                                                                                                                                                814. 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()))
                                                                                                                                                                                                816. 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()))
                                                                                                                                                                                                818. 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
                                                                                                                                                                                                820. 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())
                                                                                                                                                                                                822. 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())
                                                                                                                                                                                                824. 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()))
                                                                                                                                                                                                826. 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()))
                                                                                                                                                                                                828. 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|5.0.0)

                                                                                                                                                                                                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()))
                                                                                                                                                                                                830. 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|5.0.0)

                                                                                                                                                                                                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()))
                                                                                                                                                                                                832. 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|5.0.0)

                                                                                                                                                                                                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()))
                                                                                                                                                                                                834. 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|5.0.0)
                                                                                                                                                                                                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()))
                                                                                                                                                                                                836. 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|5.0.0)

                                                                                                                                                                                                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()))
                                                                                                                                                                                                838. 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|5.0.0)

                                                                                                                                                                                                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()))
                                                                                                                                                                                                840. 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()))
                                                                                                                                                                                                842. 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()))
                                                                                                                                                                                                844. 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()))
                                                                                                                                                                                                846. 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()))
                                                                                                                                                                                                848. 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()))
                                                                                                                                                                                                850. 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()))
                                                                                                                                                                                                852. 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()))
                                                                                                                                                                                                854. 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()))
                                                                                                                                                                                                856. 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
                                                                                                                                                                                                858. 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())
                                                                                                                                                                                                860. 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())
                                                                                                                                                                                                862. 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()))
                                                                                                                                                                                                864. 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()))
                                                                                                                                                                                                866. 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|5.0.0)

                                                                                                                                                                                                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()))
                                                                                                                                                                                                868. 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|5.0.0)

                                                                                                                                                                                                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()))
                                                                                                                                                                                                870. 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|5.0.0)

                                                                                                                                                                                                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()))
                                                                                                                                                                                                872. 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|5.0.0)
                                                                                                                                                                                                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()))
                                                                                                                                                                                                874. 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|5.0.0)

                                                                                                                                                                                                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()))
                                                                                                                                                                                                876. 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|5.0.0)

                                                                                                                                                                                                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()))
                                                                                                                                                                                                878. 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()))
                                                                                                                                                                                                880. 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()))
                                                                                                                                                                                                882. 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()))
                                                                                                                                                                                                884. 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()))
                                                                                                                                                                                                886. 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()))
                                                                                                                                                                                                888. 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()))
                                                                                                                                                                                                890. 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()))
                                                                                                                                                                                                892. 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.

                                                                                                                                                                                                ShortLKF: Punkte Belagsdauerausreißer nach unten – Tageskomponente
                                                                                                                                                                                                Control0..1
                                                                                                                                                                                                TypeBackboneElement
                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                Must Supportfalse
                                                                                                                                                                                                Obligations
                                                                                                                                                                                                  ObligationsActor
                                                                                                                                                                                                  SHALL:populateMoped KH Actor
                                                                                                                                                                                                  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()))
                                                                                                                                                                                                  894. 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
                                                                                                                                                                                                  896. 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())
                                                                                                                                                                                                  898. 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())
                                                                                                                                                                                                  900. 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()))
                                                                                                                                                                                                  902. 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()))
                                                                                                                                                                                                  904. 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()))
                                                                                                                                                                                                  906. 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()))
                                                                                                                                                                                                  908. 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()))
                                                                                                                                                                                                  910. 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()))
                                                                                                                                                                                                  912. 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|5.0.0)

                                                                                                                                                                                                  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()))
                                                                                                                                                                                                  914. 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|5.0.0)

                                                                                                                                                                                                  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()))
                                                                                                                                                                                                  916. 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
                                                                                                                                                                                                  918. 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
                                                                                                                                                                                                  • 920. 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()))
                                                                                                                                                                                                    922. 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()))
                                                                                                                                                                                                    924. 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|5.0.0)

                                                                                                                                                                                                    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()))
                                                                                                                                                                                                    926. 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|5.0.0)
                                                                                                                                                                                                    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()))
                                                                                                                                                                                                    928. 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()))
                                                                                                                                                                                                    930. 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|5.0.0)

                                                                                                                                                                                                    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()))
                                                                                                                                                                                                    932. 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|5.0.0)

                                                                                                                                                                                                    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()))
                                                                                                                                                                                                    934. 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()))
                                                                                                                                                                                                    936. 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|5.0.0)

                                                                                                                                                                                                    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()))
                                                                                                                                                                                                    938. 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()))
                                                                                                                                                                                                    940. 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()))
                                                                                                                                                                                                    942. 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
                                                                                                                                                                                                    944. 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
                                                                                                                                                                                                    • 946. 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()))
                                                                                                                                                                                                      948. 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()))
                                                                                                                                                                                                      950. 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()))
                                                                                                                                                                                                      952. 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()))
                                                                                                                                                                                                      954. 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()))
                                                                                                                                                                                                      956. 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()))
                                                                                                                                                                                                      958. 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()))
                                                                                                                                                                                                      960. 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()))
                                                                                                                                                                                                      962. 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()))
                                                                                                                                                                                                      964. 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()))
                                                                                                                                                                                                      966. 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()))
                                                                                                                                                                                                      968. 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
                                                                                                                                                                                                      970. 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())
                                                                                                                                                                                                      972. 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())
                                                                                                                                                                                                      974. 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|5.0.0)
                                                                                                                                                                                                      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()))
                                                                                                                                                                                                      976. 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|5.0.0)
                                                                                                                                                                                                      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()))
                                                                                                                                                                                                      978. 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()))
                                                                                                                                                                                                      980. 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()))
                                                                                                                                                                                                      982. 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
                                                                                                                                                                                                      984. 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())
                                                                                                                                                                                                      986. 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())
                                                                                                                                                                                                      988. 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()))
                                                                                                                                                                                                      990. 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()))
                                                                                                                                                                                                      992. 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|5.0.0)

                                                                                                                                                                                                      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()))
                                                                                                                                                                                                      994. 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|5.0.0)

                                                                                                                                                                                                      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()))
                                                                                                                                                                                                      996. 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|5.0.0)

                                                                                                                                                                                                      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()))
                                                                                                                                                                                                      998. 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|5.0.0)
                                                                                                                                                                                                      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()))
                                                                                                                                                                                                      1000. 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|5.0.0)

                                                                                                                                                                                                      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()))
                                                                                                                                                                                                      1002. 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|5.0.0)

                                                                                                                                                                                                      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()))
                                                                                                                                                                                                      1004. 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()))
                                                                                                                                                                                                      1006. 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()))
                                                                                                                                                                                                      1008. 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()))
                                                                                                                                                                                                      1010. 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()))
                                                                                                                                                                                                      1012. 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()))
                                                                                                                                                                                                      1014. 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()))
                                                                                                                                                                                                      1016. 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()))
                                                                                                                                                                                                      1018. 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()))
                                                                                                                                                                                                      1020. 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
                                                                                                                                                                                                      1022. 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())
                                                                                                                                                                                                      1024. 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())
                                                                                                                                                                                                      1026. 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()))
                                                                                                                                                                                                      1028. 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()))
                                                                                                                                                                                                      1030. 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|5.0.0)

                                                                                                                                                                                                      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()))
                                                                                                                                                                                                      1032. 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|5.0.0)

                                                                                                                                                                                                      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()))
                                                                                                                                                                                                      1034. 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|5.0.0)

                                                                                                                                                                                                      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()))
                                                                                                                                                                                                      1036. 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|5.0.0)
                                                                                                                                                                                                      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()))
                                                                                                                                                                                                      1038. 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|5.0.0)

                                                                                                                                                                                                      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()))
                                                                                                                                                                                                      1040. 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|5.0.0)

                                                                                                                                                                                                      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()))
                                                                                                                                                                                                      1042. 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()))
                                                                                                                                                                                                      1044. 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()))
                                                                                                                                                                                                      1046. 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()))
                                                                                                                                                                                                      1048. 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()))
                                                                                                                                                                                                      1050. 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()))
                                                                                                                                                                                                      1052. 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()))
                                                                                                                                                                                                      1054. 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()))
                                                                                                                                                                                                      1056. 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.

                                                                                                                                                                                                      ShortLKF: Zusatzpunkte Belagsdauerausreißer nach oben
                                                                                                                                                                                                      Control0..1
                                                                                                                                                                                                      TypeBackboneElement
                                                                                                                                                                                                      Is Modifierfalse
                                                                                                                                                                                                      Must Supportfalse
                                                                                                                                                                                                      Obligations
                                                                                                                                                                                                        ObligationsActor
                                                                                                                                                                                                        SHALL:populateMoped KH Actor
                                                                                                                                                                                                        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()))
                                                                                                                                                                                                        1058. 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
                                                                                                                                                                                                        1060. 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())
                                                                                                                                                                                                        1062. 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())
                                                                                                                                                                                                        1064. 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()))
                                                                                                                                                                                                        1066. 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()))
                                                                                                                                                                                                        1068. 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()))
                                                                                                                                                                                                        1070. 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()))
                                                                                                                                                                                                        1072. 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()))
                                                                                                                                                                                                        1074. 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()))
                                                                                                                                                                                                        1076. 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|5.0.0)

                                                                                                                                                                                                        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()))
                                                                                                                                                                                                        1078. 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|5.0.0)

                                                                                                                                                                                                        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()))
                                                                                                                                                                                                        1080. 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
                                                                                                                                                                                                        1082. 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
                                                                                                                                                                                                        • 1084. 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()))
                                                                                                                                                                                                          1086. 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()))
                                                                                                                                                                                                          1088. 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|5.0.0)

                                                                                                                                                                                                          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()))
                                                                                                                                                                                                          1090. 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|5.0.0)
                                                                                                                                                                                                          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()))
                                                                                                                                                                                                          1092. 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()))
                                                                                                                                                                                                          1094. 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|5.0.0)

                                                                                                                                                                                                          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()))
                                                                                                                                                                                                          1096. 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|5.0.0)

                                                                                                                                                                                                          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()))
                                                                                                                                                                                                          1098. 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()))
                                                                                                                                                                                                          1100. 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|5.0.0)

                                                                                                                                                                                                          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()))
                                                                                                                                                                                                          1102. 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()))
                                                                                                                                                                                                          1104. 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()))
                                                                                                                                                                                                          1106. 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
                                                                                                                                                                                                          1108. 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
                                                                                                                                                                                                          • 1110. 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()))
                                                                                                                                                                                                            1112. 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()))
                                                                                                                                                                                                            1114. 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()))
                                                                                                                                                                                                            1116. 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()))
                                                                                                                                                                                                            1118. 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()))
                                                                                                                                                                                                            1120. 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()))
                                                                                                                                                                                                            1122. 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()))
                                                                                                                                                                                                            1124. 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()))
                                                                                                                                                                                                            1126. 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()))
                                                                                                                                                                                                            1128. 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()))
                                                                                                                                                                                                            1130. 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()))
                                                                                                                                                                                                            1132. 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
                                                                                                                                                                                                            1134. 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())
                                                                                                                                                                                                            1136. 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())
                                                                                                                                                                                                            1138. 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|5.0.0)
                                                                                                                                                                                                            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()))
                                                                                                                                                                                                            1140. 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|5.0.0)
                                                                                                                                                                                                            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()))
                                                                                                                                                                                                            1142. 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()))
                                                                                                                                                                                                            1144. 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()))
                                                                                                                                                                                                            1146. 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
                                                                                                                                                                                                            1148. 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())
                                                                                                                                                                                                            1150. 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())
                                                                                                                                                                                                            1152. 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()))
                                                                                                                                                                                                            1154. 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()))
                                                                                                                                                                                                            1156. 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|5.0.0)

                                                                                                                                                                                                            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()))
                                                                                                                                                                                                            1158. 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|5.0.0)

                                                                                                                                                                                                            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()))
                                                                                                                                                                                                            1160. 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|5.0.0)

                                                                                                                                                                                                            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()))
                                                                                                                                                                                                            1162. 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|5.0.0)
                                                                                                                                                                                                            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()))
                                                                                                                                                                                                            1164. 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|5.0.0)

                                                                                                                                                                                                            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()))
                                                                                                                                                                                                            1166. 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|5.0.0)

                                                                                                                                                                                                            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()))
                                                                                                                                                                                                            1168. 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()))
                                                                                                                                                                                                            1170. 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()))
                                                                                                                                                                                                            1172. 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()))
                                                                                                                                                                                                            1174. 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()))
                                                                                                                                                                                                            1176. 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()))
                                                                                                                                                                                                            1178. 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()))
                                                                                                                                                                                                            1180. 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()))
                                                                                                                                                                                                            1182. 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()))
                                                                                                                                                                                                            1184. 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
                                                                                                                                                                                                            1186. 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())
                                                                                                                                                                                                            1188. 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())
                                                                                                                                                                                                            1190. 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()))
                                                                                                                                                                                                            1192. 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()))
                                                                                                                                                                                                            1194. 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|5.0.0)

                                                                                                                                                                                                            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()))
                                                                                                                                                                                                            1196. 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|5.0.0)

                                                                                                                                                                                                            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()))
                                                                                                                                                                                                            1198. 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|5.0.0)

                                                                                                                                                                                                            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()))
                                                                                                                                                                                                            1200. 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|5.0.0)
                                                                                                                                                                                                            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()))
                                                                                                                                                                                                            1202. 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|5.0.0)

                                                                                                                                                                                                            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()))
                                                                                                                                                                                                            1204. 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|5.0.0)

                                                                                                                                                                                                            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()))
                                                                                                                                                                                                            1206. 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()))
                                                                                                                                                                                                            1208. 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()))
                                                                                                                                                                                                            1210. 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()))
                                                                                                                                                                                                            1212. 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()))
                                                                                                                                                                                                            1214. 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()))
                                                                                                                                                                                                            1216. 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()))
                                                                                                                                                                                                            1218. 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()))
                                                                                                                                                                                                            1220. 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.

                                                                                                                                                                                                            ShortLKF: Zusatzpunkte Intensiv
                                                                                                                                                                                                            Control0..1
                                                                                                                                                                                                            TypeBackboneElement
                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                            Must Supportfalse
                                                                                                                                                                                                            Obligations
                                                                                                                                                                                                              ObligationsActor
                                                                                                                                                                                                              SHALL:populateMoped KH Actor
                                                                                                                                                                                                              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()))
                                                                                                                                                                                                              1222. 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
                                                                                                                                                                                                              1224. 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())
                                                                                                                                                                                                              1226. 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())
                                                                                                                                                                                                              1228. 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()))
                                                                                                                                                                                                              1230. 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()))
                                                                                                                                                                                                              1232. 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()))
                                                                                                                                                                                                              1234. 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()))
                                                                                                                                                                                                              1236. 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()))
                                                                                                                                                                                                              1238. 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()))
                                                                                                                                                                                                              1240. 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|5.0.0)

                                                                                                                                                                                                              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()))
                                                                                                                                                                                                              1242. 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|5.0.0)

                                                                                                                                                                                                              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()))
                                                                                                                                                                                                              1244. 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
                                                                                                                                                                                                              1246. 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
                                                                                                                                                                                                              • 1248. 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()))
                                                                                                                                                                                                                1250. 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()))
                                                                                                                                                                                                                1252. 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|5.0.0)

                                                                                                                                                                                                                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()))
                                                                                                                                                                                                                1254. 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|5.0.0)
                                                                                                                                                                                                                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()))
                                                                                                                                                                                                                1256. 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()))
                                                                                                                                                                                                                1258. 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|5.0.0)

                                                                                                                                                                                                                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()))
                                                                                                                                                                                                                1260. 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|5.0.0)

                                                                                                                                                                                                                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()))
                                                                                                                                                                                                                1262. 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()))
                                                                                                                                                                                                                1264. 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|5.0.0)

                                                                                                                                                                                                                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()))
                                                                                                                                                                                                                1266. 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()))
                                                                                                                                                                                                                1268. 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()))
                                                                                                                                                                                                                1270. 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
                                                                                                                                                                                                                1272. 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
                                                                                                                                                                                                                • 1274. 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()))
                                                                                                                                                                                                                  1276. 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()))
                                                                                                                                                                                                                  1278. 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()))
                                                                                                                                                                                                                  1280. 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()))
                                                                                                                                                                                                                  1282. 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()))
                                                                                                                                                                                                                  1284. 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()))
                                                                                                                                                                                                                  1286. 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()))
                                                                                                                                                                                                                  1288. 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()))
                                                                                                                                                                                                                  1290. 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()))
                                                                                                                                                                                                                  1292. 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()))
                                                                                                                                                                                                                  1294. 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()))
                                                                                                                                                                                                                  1296. 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
                                                                                                                                                                                                                  1298. 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())
                                                                                                                                                                                                                  1300. 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())
                                                                                                                                                                                                                  1302. 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|5.0.0)
                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                  1304. 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|5.0.0)
                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                  1306. 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()))
                                                                                                                                                                                                                  1308. 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()))
                                                                                                                                                                                                                  1310. 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
                                                                                                                                                                                                                  1312. 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())
                                                                                                                                                                                                                  1314. 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())
                                                                                                                                                                                                                  1316. 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()))
                                                                                                                                                                                                                  1318. 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()))
                                                                                                                                                                                                                  1320. 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|5.0.0)

                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                  1322. 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|5.0.0)

                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                  1324. 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|5.0.0)

                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                  1326. 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|5.0.0)
                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                  1328. 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|5.0.0)

                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                  1330. 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|5.0.0)

                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                  1332. 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()))
                                                                                                                                                                                                                  1334. 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()))
                                                                                                                                                                                                                  1336. 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()))
                                                                                                                                                                                                                  1338. 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()))
                                                                                                                                                                                                                  1340. 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()))
                                                                                                                                                                                                                  1342. 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()))
                                                                                                                                                                                                                  1344. 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()))
                                                                                                                                                                                                                  1346. 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()))
                                                                                                                                                                                                                  1348. 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
                                                                                                                                                                                                                  1350. 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())
                                                                                                                                                                                                                  1352. 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())
                                                                                                                                                                                                                  1354. 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()))
                                                                                                                                                                                                                  1356. 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()))
                                                                                                                                                                                                                  1358. 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|5.0.0)

                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                  1360. 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|5.0.0)

                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                  1362. 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|5.0.0)

                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                  1364. 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|5.0.0)
                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                  1366. 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|5.0.0)

                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                  1368. 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|5.0.0)

                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                  1370. 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()))
                                                                                                                                                                                                                  1372. 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()))
                                                                                                                                                                                                                  1374. 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()))
                                                                                                                                                                                                                  1376. 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()))
                                                                                                                                                                                                                  1378. 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()))
                                                                                                                                                                                                                  1380. 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()))
                                                                                                                                                                                                                  1382. 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()))
                                                                                                                                                                                                                  1384. 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.

                                                                                                                                                                                                                  ShortLKF: Zusatzpunkte Mehrfachleistungen
                                                                                                                                                                                                                  Control0..1
                                                                                                                                                                                                                  TypeBackboneElement
                                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                                  Must Supportfalse
                                                                                                                                                                                                                  Obligations
                                                                                                                                                                                                                    ObligationsActor
                                                                                                                                                                                                                    SHALL:populateMoped KH Actor
                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                    1386. 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
                                                                                                                                                                                                                    1388. 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())
                                                                                                                                                                                                                    1390. 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())
                                                                                                                                                                                                                    1392. 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()))
                                                                                                                                                                                                                    1394. 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()))
                                                                                                                                                                                                                    1396. 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()))
                                                                                                                                                                                                                    1398. 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()))
                                                                                                                                                                                                                    1400. 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()))
                                                                                                                                                                                                                    1402. 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()))
                                                                                                                                                                                                                    1404. 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|5.0.0)

                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                    1406. 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|5.0.0)

                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                    1408. 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
                                                                                                                                                                                                                    1410. 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
                                                                                                                                                                                                                    • 1412. 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()))
                                                                                                                                                                                                                      1414. 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()))
                                                                                                                                                                                                                      1416. 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|5.0.0)

                                                                                                                                                                                                                      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()))
                                                                                                                                                                                                                      1418. 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|5.0.0)
                                                                                                                                                                                                                      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()))
                                                                                                                                                                                                                      1420. 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()))
                                                                                                                                                                                                                      1422. 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|5.0.0)

                                                                                                                                                                                                                      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()))
                                                                                                                                                                                                                      1424. 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|5.0.0)

                                                                                                                                                                                                                      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()))
                                                                                                                                                                                                                      1426. 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()))
                                                                                                                                                                                                                      1428. 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|5.0.0)

                                                                                                                                                                                                                      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()))
                                                                                                                                                                                                                      1430. 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()))
                                                                                                                                                                                                                      1432. 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()))
                                                                                                                                                                                                                      1434. 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
                                                                                                                                                                                                                      1436. 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
                                                                                                                                                                                                                      • 1438. 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()))
                                                                                                                                                                                                                        1440. 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()))
                                                                                                                                                                                                                        1442. 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()))
                                                                                                                                                                                                                        1444. 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()))
                                                                                                                                                                                                                        1446. 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()))
                                                                                                                                                                                                                        1448. 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()))
                                                                                                                                                                                                                        1450. 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()))
                                                                                                                                                                                                                        1452. 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()))
                                                                                                                                                                                                                        1454. 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()))
                                                                                                                                                                                                                        1456. 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()))
                                                                                                                                                                                                                        1458. 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()))
                                                                                                                                                                                                                        1460. 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
                                                                                                                                                                                                                        1462. 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())
                                                                                                                                                                                                                        1464. 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())
                                                                                                                                                                                                                        1466. 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|5.0.0)
                                                                                                                                                                                                                        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()))
                                                                                                                                                                                                                        1468. 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|5.0.0)
                                                                                                                                                                                                                        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()))
                                                                                                                                                                                                                        1470. 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()))
                                                                                                                                                                                                                        1472. 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()))
                                                                                                                                                                                                                        1474. 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
                                                                                                                                                                                                                        1476. 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())
                                                                                                                                                                                                                        1478. 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())
                                                                                                                                                                                                                        1480. 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()))
                                                                                                                                                                                                                        1482. 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()))
                                                                                                                                                                                                                        1484. 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|5.0.0)

                                                                                                                                                                                                                        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()))
                                                                                                                                                                                                                        1486. 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|5.0.0)

                                                                                                                                                                                                                        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()))
                                                                                                                                                                                                                        1488. 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|5.0.0)

                                                                                                                                                                                                                        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()))
                                                                                                                                                                                                                        1490. 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|5.0.0)
                                                                                                                                                                                                                        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()))
                                                                                                                                                                                                                        1492. 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|5.0.0)

                                                                                                                                                                                                                        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()))
                                                                                                                                                                                                                        1494. 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|5.0.0)

                                                                                                                                                                                                                        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()))
                                                                                                                                                                                                                        1496. 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()))
                                                                                                                                                                                                                        1498. 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()))
                                                                                                                                                                                                                        1500. 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()))
                                                                                                                                                                                                                        1502. 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()))
                                                                                                                                                                                                                        1504. 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()))
                                                                                                                                                                                                                        1506. 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()))
                                                                                                                                                                                                                        1508. 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()))
                                                                                                                                                                                                                        1510. 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()))
                                                                                                                                                                                                                        1512. 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
                                                                                                                                                                                                                        1514. 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())
                                                                                                                                                                                                                        1516. 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())
                                                                                                                                                                                                                        1518. 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()))
                                                                                                                                                                                                                        1520. 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()))
                                                                                                                                                                                                                        1522. 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|5.0.0)

                                                                                                                                                                                                                        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()))
                                                                                                                                                                                                                        1524. 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|5.0.0)

                                                                                                                                                                                                                        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()))
                                                                                                                                                                                                                        1526. 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|5.0.0)

                                                                                                                                                                                                                        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()))
                                                                                                                                                                                                                        1528. 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|5.0.0)
                                                                                                                                                                                                                        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()))
                                                                                                                                                                                                                        1530. 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|5.0.0)

                                                                                                                                                                                                                        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()))
                                                                                                                                                                                                                        1532. 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|5.0.0)

                                                                                                                                                                                                                        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()))
                                                                                                                                                                                                                        1534. 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()))
                                                                                                                                                                                                                        1536. 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()))
                                                                                                                                                                                                                        1538. 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()))
                                                                                                                                                                                                                        1540. 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()))
                                                                                                                                                                                                                        1542. 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()))
                                                                                                                                                                                                                        1544. 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()))
                                                                                                                                                                                                                        1546. 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()))
                                                                                                                                                                                                                        1548. 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.

                                                                                                                                                                                                                        ShortLKF: Punkte spezieller Bereiche (tageweise)
                                                                                                                                                                                                                        Control0..1
                                                                                                                                                                                                                        TypeBackboneElement
                                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                                        Must Supportfalse
                                                                                                                                                                                                                        Obligations
                                                                                                                                                                                                                          ObligationsActor
                                                                                                                                                                                                                          SHALL:populateMoped KH Actor
                                                                                                                                                                                                                          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()))
                                                                                                                                                                                                                          1550. 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
                                                                                                                                                                                                                          1552. 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())
                                                                                                                                                                                                                          1554. 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())
                                                                                                                                                                                                                          1556. 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()))
                                                                                                                                                                                                                          1558. 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()))
                                                                                                                                                                                                                          1560. 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()))
                                                                                                                                                                                                                          1562. 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()))
                                                                                                                                                                                                                          1564. 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()))
                                                                                                                                                                                                                          1566. 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()))
                                                                                                                                                                                                                          1568. 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|5.0.0)

                                                                                                                                                                                                                          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()))
                                                                                                                                                                                                                          1570. 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|5.0.0)

                                                                                                                                                                                                                          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()))
                                                                                                                                                                                                                          1572. 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
                                                                                                                                                                                                                          1574. 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
                                                                                                                                                                                                                          • 1576. 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()))
                                                                                                                                                                                                                            1578. 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()))
                                                                                                                                                                                                                            1580. 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|5.0.0)

                                                                                                                                                                                                                            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()))
                                                                                                                                                                                                                            1582. 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|5.0.0)
                                                                                                                                                                                                                            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()))
                                                                                                                                                                                                                            1584. 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()))
                                                                                                                                                                                                                            1586. 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|5.0.0)

                                                                                                                                                                                                                            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()))
                                                                                                                                                                                                                            1588. 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|5.0.0)

                                                                                                                                                                                                                            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()))
                                                                                                                                                                                                                            1590. 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()))
                                                                                                                                                                                                                            1592. 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|5.0.0)

                                                                                                                                                                                                                            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()))
                                                                                                                                                                                                                            1594. 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()))
                                                                                                                                                                                                                            1596. 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()))
                                                                                                                                                                                                                            1598. 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
                                                                                                                                                                                                                            1600. 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
                                                                                                                                                                                                                            • 1602. 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()))
                                                                                                                                                                                                                              1604. 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()))
                                                                                                                                                                                                                              1606. 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()))
                                                                                                                                                                                                                              1608. 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()))
                                                                                                                                                                                                                              1610. 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()))
                                                                                                                                                                                                                              1612. 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()))
                                                                                                                                                                                                                              1614. 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()))
                                                                                                                                                                                                                              1616. 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()))
                                                                                                                                                                                                                              1618. 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()))
                                                                                                                                                                                                                              1620. 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()))
                                                                                                                                                                                                                              1622. 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()))
                                                                                                                                                                                                                              1624. 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
                                                                                                                                                                                                                              1626. 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())
                                                                                                                                                                                                                              1628. 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())
                                                                                                                                                                                                                              1630. 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|5.0.0)
                                                                                                                                                                                                                              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()))
                                                                                                                                                                                                                              1632. 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|5.0.0)
                                                                                                                                                                                                                              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()))
                                                                                                                                                                                                                              1634. 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()))
                                                                                                                                                                                                                              1636. 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()))
                                                                                                                                                                                                                              1638. 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
                                                                                                                                                                                                                              1640. 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())
                                                                                                                                                                                                                              1642. 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())
                                                                                                                                                                                                                              1644. 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()))
                                                                                                                                                                                                                              1646. 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()))
                                                                                                                                                                                                                              1648. 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|5.0.0)

                                                                                                                                                                                                                              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()))
                                                                                                                                                                                                                              1650. 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|5.0.0)

                                                                                                                                                                                                                              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()))
                                                                                                                                                                                                                              1652. 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|5.0.0)

                                                                                                                                                                                                                              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()))
                                                                                                                                                                                                                              1654. 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|5.0.0)
                                                                                                                                                                                                                              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()))
                                                                                                                                                                                                                              1656. 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|5.0.0)

                                                                                                                                                                                                                              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()))
                                                                                                                                                                                                                              1658. 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|5.0.0)

                                                                                                                                                                                                                              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()))
                                                                                                                                                                                                                              1660. 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()))
                                                                                                                                                                                                                              1662. 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()))
                                                                                                                                                                                                                              1664. 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()))
                                                                                                                                                                                                                              1666. 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()))
                                                                                                                                                                                                                              1668. 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()))
                                                                                                                                                                                                                              1670. 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()))
                                                                                                                                                                                                                              1672. 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()))
                                                                                                                                                                                                                              1674. 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()))
                                                                                                                                                                                                                              1676. 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
                                                                                                                                                                                                                              1678. 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())
                                                                                                                                                                                                                              1680. 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())
                                                                                                                                                                                                                              1682. 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()))
                                                                                                                                                                                                                              1684. 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()))
                                                                                                                                                                                                                              1686. 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|5.0.0)

                                                                                                                                                                                                                              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()))
                                                                                                                                                                                                                              1688. 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|5.0.0)

                                                                                                                                                                                                                              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()))
                                                                                                                                                                                                                              1690. 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|5.0.0)

                                                                                                                                                                                                                              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()))
                                                                                                                                                                                                                              1692. 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|5.0.0)
                                                                                                                                                                                                                              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()))
                                                                                                                                                                                                                              1694. 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|5.0.0)

                                                                                                                                                                                                                              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()))
                                                                                                                                                                                                                              1696. 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|5.0.0)

                                                                                                                                                                                                                              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()))
                                                                                                                                                                                                                              1698. 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()))
                                                                                                                                                                                                                              1700. 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()))
                                                                                                                                                                                                                              1702. 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()))
                                                                                                                                                                                                                              1704. 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()))
                                                                                                                                                                                                                              1706. 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()))
                                                                                                                                                                                                                              1708. 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()))
                                                                                                                                                                                                                              1710. 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()))
                                                                                                                                                                                                                              1712. 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.

                                                                                                                                                                                                                              ShortLKF: Punkte total
                                                                                                                                                                                                                              Control1..1
                                                                                                                                                                                                                              TypeBackboneElement
                                                                                                                                                                                                                              Is Modifierfalse
                                                                                                                                                                                                                              Must Supportfalse
                                                                                                                                                                                                                              Obligations
                                                                                                                                                                                                                                ObligationsActor
                                                                                                                                                                                                                                SHALL:populateMoped KH Actor
                                                                                                                                                                                                                                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()))
                                                                                                                                                                                                                                1714. 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
                                                                                                                                                                                                                                1716. 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())
                                                                                                                                                                                                                                1718. 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())
                                                                                                                                                                                                                                1720. 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()))
                                                                                                                                                                                                                                1722. 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()))
                                                                                                                                                                                                                                1724. 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()))
                                                                                                                                                                                                                                1726. 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()))
                                                                                                                                                                                                                                1728. 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()))
                                                                                                                                                                                                                                1730. 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()))
                                                                                                                                                                                                                                1732. 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|5.0.0)

                                                                                                                                                                                                                                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()))
                                                                                                                                                                                                                                1734. 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|5.0.0)

                                                                                                                                                                                                                                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()))
                                                                                                                                                                                                                                1736. 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
                                                                                                                                                                                                                                1738. 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
                                                                                                                                                                                                                                • 1740. 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()))
                                                                                                                                                                                                                                  1742. 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()))
                                                                                                                                                                                                                                  1744. 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|5.0.0)

                                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                                  1746. 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|5.0.0)
                                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                                  1748. 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()))
                                                                                                                                                                                                                                  1750. 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|5.0.0)

                                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                                  1752. 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|5.0.0)

                                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                                  1754. 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()))
                                                                                                                                                                                                                                  1756. 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|5.0.0)

                                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                                  1758. 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()))
                                                                                                                                                                                                                                  1760. 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()))
                                                                                                                                                                                                                                  1762. 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
                                                                                                                                                                                                                                  1764. 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
                                                                                                                                                                                                                                  • 1766. 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()))
                                                                                                                                                                                                                                    1768. 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()))
                                                                                                                                                                                                                                    1770. 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()))
                                                                                                                                                                                                                                    1772. 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()))
                                                                                                                                                                                                                                    1774. 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()))
                                                                                                                                                                                                                                    1776. 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()))
                                                                                                                                                                                                                                    1778. 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()))
                                                                                                                                                                                                                                    1780. 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()))
                                                                                                                                                                                                                                    1782. 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()))
                                                                                                                                                                                                                                    1784. 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()))
                                                                                                                                                                                                                                    1786. 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()))
                                                                                                                                                                                                                                    1788. 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
                                                                                                                                                                                                                                    1790. 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())
                                                                                                                                                                                                                                    1792. 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())
                                                                                                                                                                                                                                    1794. 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|5.0.0)
                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                    1796. 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|5.0.0)
                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                    1798. 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()))
                                                                                                                                                                                                                                    1800. 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()))
                                                                                                                                                                                                                                    1802. 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
                                                                                                                                                                                                                                    1804. 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())
                                                                                                                                                                                                                                    1806. 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())
                                                                                                                                                                                                                                    1808. 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()))
                                                                                                                                                                                                                                    1810. 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()))
                                                                                                                                                                                                                                    1812. 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|5.0.0)

                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                    1814. 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|5.0.0)

                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                    1816. 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|5.0.0)

                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                    1818. 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|5.0.0)
                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                    1820. 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|5.0.0)

                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                    1822. 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|5.0.0)

                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                    1824. 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()))
                                                                                                                                                                                                                                    1826. 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()))
                                                                                                                                                                                                                                    1828. 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()))
                                                                                                                                                                                                                                    1830. 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()))
                                                                                                                                                                                                                                    1832. 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()))
                                                                                                                                                                                                                                    1834. 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()))
                                                                                                                                                                                                                                    1836. 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()))
                                                                                                                                                                                                                                    1838. 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()))
                                                                                                                                                                                                                                    1840. 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
                                                                                                                                                                                                                                    1842. 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())
                                                                                                                                                                                                                                    1844. 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())
                                                                                                                                                                                                                                    1846. 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()))
                                                                                                                                                                                                                                    1848. 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()))
                                                                                                                                                                                                                                    1850. 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|5.0.0)

                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                    1852. 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|5.0.0)

                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                    1854. 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|5.0.0)

                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                    1856. 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|5.0.0)
                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                    1858. 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|5.0.0)

                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                    1860. 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|5.0.0)

                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                    1862. 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()))
                                                                                                                                                                                                                                    1864. 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()))
                                                                                                                                                                                                                                    1866. 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()))
                                                                                                                                                                                                                                    1868. 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()))
                                                                                                                                                                                                                                    1870. 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()))
                                                                                                                                                                                                                                    1872. 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()))
                                                                                                                                                                                                                                    1874. 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()))
                                                                                                                                                                                                                                    1876. 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()))