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: MOPED VAERequest

Official URL: https://elga.moped.at/StructureDefinition/MopedVAERequest Version: 0.1.0
Draft as of 2025-10-31 Responsible: ELGA GmbH Computable Name: MopedVAERequest

MOPED Profil für die Anfrage der Versichertenanspruchserklärung VAE.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim 0..* Claim Claim, Pre-determination or Pre-authorization
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... type OΣ 1..1 CodeableConcept Category or discipline
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
Required Pattern: At least the following
ObligationsActor
SHALL:populate Moped KH Actor
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: institutional
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... use OΣ 1..1 code claim | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
Required Pattern: preauthorization
ObligationsActor
SHALL:populate Moped KH Actor
... patient OΣ 1..1 Reference(HL7® AT Core Patient Profile) The recipient of the products and services
ObligationsActor
SHALL:handle Moped Device Actor
... created Σ 1..1 dateTime Resource creation date
... insurer OΣ 1..1 Reference(SV Organization) Target
ObligationsActor
SHALL:handle Moped Device Actor
... provider OΣ 1..1 Reference(KH Organization) Party responsible for the claim
ObligationsActor
SHALL:handle Moped Device Actor
... Slices for encounter 1..* Reference(Encounter) Encounters associated with the listed treatments
Slice: Unordered, Open by profile:resolve()
.... encounter:MopedEncounter O 1..1 Reference(MOPED Encounter) Generelle Informationen zu Aufnahme und Entlassung des Patienten
ObligationsActor
SHALL:handle Moped Device Actor
.... encounter:TransferEncounter O 0..* Reference(MOPED TransferEncounter) Informationen zu Verlegungen innerhalb oder zwischen Krankenanstalten
ObligationsActor
SHALL:handle Moped Device Actor
... Slices for supportingInfo 1..* BackboneElement Supporting information
Slice: Unordered, Open by value:category
.... supportingInfo:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
.... supportingInfo:Sonderklasse O 0..* BackboneElement KaOrg: Allgemeine Gebührenklasse/Sonderklasse
ObligationsActor
SHALL:populate Moped KH Actor
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: KLAS
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... code 1..1 CodeableConcept KaOrg: Verlegung Klasse
Binding: Sonderklasse ValueSet (required)
..... Slices for timing[x] 1..1 Period When it occurred
Slice: Unordered, Closed by type:$this
...... timing[x]:timingPeriod 1..1 Period KaOrg: Aufnahme-, Verlegungsdatum
.... supportingInfo:VerdachtFremdverschulden O 1..1 BackboneElement KaOrg: Fremdversschluden
ObligationsActor
SHALL:populate Moped KH Actor
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: FREVER
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... value[x] 1..1 boolean Data to be provided
.... supportingInfo:Verlaengerungstage O 0..1 BackboneElement KaOrg: Anzahl der Verlängerungstage
ObligationsActor
SHALL:populate Moped KH Actor
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: VERLAENG
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... Slices for value[x] 0..1 Data to be provided
Slice: Unordered, Open by type:$this
...... valueBoolean boolean
...... valueString string
...... valueQuantity Quantity
...... valueAttachment Attachment
...... valueReference Reference(Resource)
...... valueIdentifier Identifier
...... value[x]:valueQuantity 0..1 Quantity Data to be provided
....... value Σ 1..1 decimal Verlängerungstage
....... comparator ?!Σ 0..1 code < | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
....... unit Σ 0..1 string Unit representation
Required Pattern: day
....... system ΣC 0..1 uri System that defines coded unit form
Required Pattern: http://unitsofmeasure.org
....... code ΣC 0..1 code Coded form of the unit
Required Pattern: day

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Claim.status Base required Financial Resource Status Codes 📍5.0.0 FHIR Std.
Claim.type Base extensible Claim Type Codes 📍5.0.0 FHIR Std.
Claim.use Base required Use 📍5.0.0 FHIR Std.
Claim.supportingInfo.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Sonderklasse.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Sonderklasse.​code Base required Sonderklasse ValueSet 📦0.1.0 This IG
Claim.supportingInfo:VerdachtFremdverschulden.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Verlaengerungstage.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Verlaengerungstage.​value[x]:valueQuantity.​comparator Base required QuantityComparator 📍5.0.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Claim If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Claim 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 error Claim 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 error Claim If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Claim A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from Claim

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim Claim
... status O 1..1 code active | cancelled | draft | entered-in-error
ObligationsActor
SHALL:handle Moped Device Actor
SHALL:populate Moped KH Actor
... type O 1..1 CodeableConcept Category or discipline
Required Pattern: At least the following
ObligationsActor
SHALL:populate Moped KH Actor
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: institutional
... use O 1..1 code claim | preauthorization | predetermination
Required Pattern: preauthorization
ObligationsActor
SHALL:populate Moped KH Actor
... insurer O 1..1 Reference(SV Organization) Target
ObligationsActor
SHALL:handle Moped Device Actor
... provider O 1..1 Reference(KH Organization) Party responsible for the claim
ObligationsActor
SHALL:handle Moped Device Actor
... related
.... claim O 0..1 Reference(MOPED VAERequest) Reference to the related claim
ObligationsActor
SHALL:populate Moped KH Actor
... Slices for encounter 1..* Reference(Encounter) Encounters associated with the listed treatments
Slice: Unordered, Open by profile:resolve()
.... encounter:MopedEncounter O 1..1 Reference(MOPED Encounter) Generelle Informationen zu Aufnahme und Entlassung des Patienten
ObligationsActor
SHALL:handle Moped Device Actor
.... encounter:TransferEncounter O 0..* Reference(MOPED TransferEncounter) Informationen zu Verlegungen innerhalb oder zwischen Krankenanstalten
ObligationsActor
SHALL:handle Moped Device Actor
... Slices for supportingInfo 1..* BackboneElement Supporting information
Slice: Unordered, Open by value:category
.... supportingInfo:All Slices Content/Rules for all slices
..... code
...... coding 0..* Coding Code defined by a terminology system
Binding: MOPED VAESupportingInformationCategory (required)
.... supportingInfo:Sonderklasse O 0..* BackboneElement KaOrg: Allgemeine Gebührenklasse/Sonderklasse
ObligationsActor
SHALL:populate Moped KH Actor
..... category 1..1 CodeableConcept Classification of the supplied information
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: KLAS
..... code 1..1 CodeableConcept KaOrg: Verlegung Klasse
Binding: Sonderklasse ValueSet (required)
..... Slices for timing[x] 1..1 Period When it occurred
Slice: Unordered, Open by type:$this
...... timing[x]:timingPeriod 1..1 Period KaOrg: Aufnahme-, Verlegungsdatum
.... supportingInfo:VerdachtFremdverschulden O 1..1 BackboneElement KaOrg: Fremdversschluden
ObligationsActor
SHALL:populate Moped KH Actor
..... category 1..1 CodeableConcept Classification of the supplied information
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: FREVER
..... value[x] 1..1 boolean Data to be provided
.... supportingInfo:Verlaengerungstage O 0..1 BackboneElement KaOrg: Anzahl der Verlängerungstage
ObligationsActor
SHALL:populate Moped KH Actor
..... category 1..1 CodeableConcept Classification of the supplied information
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: VERLAENG
..... Slices for value[x] 0..1 boolean, string, Quantity, Attachment, Reference(Resource), Identifier Data to be provided
Slice: Unordered, Open by type:$this
...... value[x]:valueQuantity 0..1 Quantity Data to be provided
....... value 1..1 decimal Verlängerungstage
....... unit 0..1 string Unit representation
Required Pattern: day
....... system 0..1 uri System that defines coded unit form
Required Pattern: http://unitsofmeasure.org
....... code 0..1 code Coded form of the unit
Required Pattern: day
... diagnosis
.... diagnosis[x] O 1..1 Reference(MOPED Condition) Nature of illness or problem
ObligationsActor
SHALL:populate Moped KH Actor
... insurance
.... coverage O 1..1 Reference(MOPED Coverage) Insurance information
ObligationsActor
SHALL:handle Moped Device Actor
... accident
.... date O 1..1 date KaOrg: Ereignis-/Unfalldatum (echtes Unfalldatum)
ObligationsActor
SHALL:populate Moped KH Actor
.... type O 1..1 CodeableConcept KaOrg: Verdacht auf Arbeits-/Schülerunfall
Binding: Verdacht auf Arbeits- oder Schuelerunfall ValueSet (required)
ObligationsActor
SHALL:populate Moped KH Actor

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Claim.supportingInfo.​code.coding Base required MOPED VAESupportingInformationCategory 📦0.1.0 This IG
Claim.supportingInfo:Sonderklasse.​code Base required Sonderklasse ValueSet 📦0.1.0 This IG
Claim.accident.type Base required Verdacht auf Arbeits- oder Schuelerunfall ValueSet 📦0.1.0 This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim 0..* Claim Claim, Pre-determination or Pre-authorization
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: AllLanguages (required): IETF language tag for a human language
Additional BindingsPurpose
CommonLanguages Starter
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier Business Identifier for claim
... traceNumber 0..* Identifier Number for tracking
... status ?!OΣ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
ObligationsActor
SHALL:handle Moped Device Actor
SHALL:populate Moped KH Actor
... type OΣ 1..1 CodeableConcept Category or discipline
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
Required Pattern: At least the following
ObligationsActor
SHALL:populate Moped KH Actor
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: institutional
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subType 0..1 CodeableConcept More granular claim type
Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode.
... use OΣ 1..1 code claim | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
Required Pattern: preauthorization
ObligationsActor
SHALL:populate Moped KH Actor
... patient OΣ 1..1 Reference(HL7® AT Core Patient Profile) The recipient of the products and services
ObligationsActor
SHALL:handle Moped Device Actor
... billablePeriod Σ 0..1 Period Relevant time frame for the claim
... created Σ 1..1 dateTime Resource creation date
... enterer 0..1 Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) Author of the claim
... insurer OΣ 1..1 Reference(SV Organization) Target
ObligationsActor
SHALL:handle Moped Device Actor
... provider OΣ 1..1 Reference(KH Organization) Party responsible for the claim
ObligationsActor
SHALL:handle Moped Device Actor
... priority Σ 0..1 CodeableConcept Desired processing urgency
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
... fundsReserve 0..1 CodeableConcept For whom to reserve funds
Binding: FundsReservationCodes (example): For whom funds are to be reserved: (Patient, Provider, None).
... related 0..* BackboneElement Prior or corollary claims
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... claim O 0..1 Reference(MOPED VAERequest) Reference to the related claim
ObligationsActor
SHALL:populate Moped KH Actor
.... relationship 0..1 CodeableConcept How the reference claim is related
Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.
.... reference 0..1 Identifier File or case reference
... prescription 0..1 Reference(DeviceRequest | MedicationRequest | VisionPrescription) Prescription authorizing services and products
... originalPrescription 0..1 Reference(DeviceRequest | MedicationRequest | VisionPrescription) Original prescription if superseded by fulfiller
... payee 0..1 BackboneElement Recipient of benefits payable
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 CodeableConcept Category of recipient
Binding: ClaimPayeeTypeCodes (example): A code for the party to be reimbursed.
.... party 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson) Recipient reference
... referral 0..1 Reference(ServiceRequest) Treatment referral
... Slices for encounter 1..* Reference(Encounter) Encounters associated with the listed treatments
Slice: Unordered, Open by profile:resolve()
.... encounter:MopedEncounter O 1..1 Reference(MOPED Encounter) Generelle Informationen zu Aufnahme und Entlassung des Patienten
ObligationsActor
SHALL:handle Moped Device Actor
.... encounter:TransferEncounter O 0..* Reference(MOPED TransferEncounter) Informationen zu Verlegungen innerhalb oder zwischen Krankenanstalten
ObligationsActor
SHALL:handle Moped Device Actor
... facility 0..1 Reference(Location | Organization) Servicing facility
... diagnosisRelatedGroup 0..1 CodeableConcept Package billing code
Binding: ExampleDiagnosisRelatedGroupCodes (example)
... event 0..* BackboneElement Event information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 CodeableConcept Specific event
Binding: DatesTypeCodes (example)
.... when[x] 1..1 Occurance date or period
..... whenDateTime dateTime
..... whenPeriod Period
... careTeam 0..* BackboneElement Members of the care team
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Order of care team
.... provider 1..1 Reference(Practitioner | PractitionerRole | Organization) Practitioner or organization
.... responsible 0..1 boolean Indicator of the lead practitioner
.... role 0..1 CodeableConcept Function within the team
Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.
.... specialty 0..1 CodeableConcept Practitioner or provider specialization
Binding: ExampleProviderQualificationCodes (example)
... Slices for supportingInfo 1..* BackboneElement Supporting information
Slice: Unordered, Open by value:category
.... supportingInfo:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
..... code 0..1 CodeableConcept Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
Binding: MOPED VAESupportingInformationCategory (required)
...... text Σ 0..1 string Plain text representation of the concept
..... timing[x] 0..1 When it occurred
...... timingDate date
...... timingPeriod Period
..... value[x] 0..1 Data to be provided
...... valueBoolean boolean
...... valueString string
...... valueQuantity Quantity
...... valueAttachment Attachment
...... valueReference Reference(Resource)
...... valueIdentifier Identifier
..... reason 0..1 CodeableConcept Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
.... supportingInfo:Sonderklasse O 0..* BackboneElement KaOrg: Allgemeine Gebührenklasse/Sonderklasse
ObligationsActor
SHALL:populate Moped KH Actor
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: KLAS
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... code 1..1 CodeableConcept KaOrg: Verlegung Klasse
Binding: Sonderklasse ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
Binding: MOPED VAESupportingInformationCategory (required)
...... text Σ 0..1 string Plain text representation of the concept
..... Slices for timing[x] 1..1 Period When it occurred
Slice: Unordered, Closed by type:$this
...... timing[x]:timingPeriod 1..1 Period KaOrg: Aufnahme-, Verlegungsdatum
..... value[x] 0..1 Data to be provided
...... valueBoolean boolean
...... valueString string
...... valueQuantity Quantity
...... valueAttachment Attachment
...... valueReference Reference(Resource)
...... valueIdentifier Identifier
..... reason 0..1 CodeableConcept Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
.... supportingInfo:VerdachtFremdverschulden O 1..1 BackboneElement KaOrg: Fremdversschluden
ObligationsActor
SHALL:populate Moped KH Actor
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: FREVER
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... code 0..1 CodeableConcept Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
Binding: MOPED VAESupportingInformationCategory (required)
...... text Σ 0..1 string Plain text representation of the concept
..... timing[x] 0..1 When it occurred
...... timingDate date
...... timingPeriod Period
..... value[x] 1..1 boolean Data to be provided
..... reason 0..1 CodeableConcept Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
.... supportingInfo:Verlaengerungstage O 0..1 BackboneElement KaOrg: Anzahl der Verlängerungstage
ObligationsActor
SHALL:populate Moped KH Actor
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: VERLAENG
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... code 0..1 CodeableConcept Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
Binding: MOPED VAESupportingInformationCategory (required)
...... text Σ 0..1 string Plain text representation of the concept
..... timing[x] 0..1 When it occurred
...... timingDate date
...... timingPeriod Period
..... Slices for value[x] 0..1 Data to be provided
Slice: Unordered, Open by type:$this
...... valueBoolean boolean
...... valueString string
...... valueQuantity Quantity
...... valueAttachment Attachment
...... valueReference Reference(Resource)
...... valueIdentifier Identifier
...... value[x]:valueQuantity 0..1 Quantity Data to be provided
....... id 0..1 id Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... value Σ 1..1 decimal Verlängerungstage
....... comparator ?!Σ 0..1 code < | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
....... unit Σ 0..1 string Unit representation
Required Pattern: day
....... system ΣC 0..1 uri System that defines coded unit form
Required Pattern: http://unitsofmeasure.org
....... code ΣC 0..1 code Coded form of the unit
Required Pattern: day
..... reason 0..1 CodeableConcept Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
... diagnosis 0..* BackboneElement Pertinent diagnosis information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Diagnosis instance identifier
.... diagnosis[x] O 1..1 Reference(MOPED Condition) Nature of illness or problem
ObligationsActor
SHALL:populate Moped KH Actor
.... type 0..* CodeableConcept Timing or nature of the diagnosis
Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
.... onAdmission 0..1 CodeableConcept Present on admission
Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
... procedure 0..* BackboneElement Clinical procedures performed
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Procedure instance identifier
.... type 0..* CodeableConcept Category of Procedure
Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
.... date 0..1 dateTime When the procedure was performed
.... procedure[x] 1..1 Specific clinical procedure
Binding: ICD10ProcedureCodes (example): Example ICD10 Procedure codes.
..... procedureCodeableConcept CodeableConcept
..... procedureReference Reference(Procedure)
.... udi 0..* Reference(Device) Unique device identifier
... insurance Σ 0..* BackboneElement Patient insurance information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 1..1 positiveInt Insurance instance identifier
.... focal Σ 1..1 boolean Coverage to be used for adjudication
.... identifier 0..1 Identifier Pre-assigned Claim number
.... coverage OΣ 1..1 Reference(MOPED Coverage) Insurance information
ObligationsActor
SHALL:handle Moped Device Actor
.... businessArrangement 0..1 string Additional provider contract number
.... preAuthRef 0..* string Prior authorization reference number
.... claimResponse 0..1 Reference(ClaimResponse) Adjudication results
... accident 0..1 BackboneElement Details of the event
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... date O 1..1 date KaOrg: Ereignis-/Unfalldatum (echtes Unfalldatum)
ObligationsActor
SHALL:populate Moped KH Actor
.... type O 1..1 CodeableConcept KaOrg: Verdacht auf Arbeits-/Schülerunfall
Binding: Verdacht auf Arbeits- oder Schuelerunfall ValueSet (required)
ObligationsActor
SHALL:populate Moped KH Actor
.... location[x] 0..1 Where the event occurred
..... locationAddress Address
..... locationReference Reference(Location)
... patientPaid 0..1 Money Paid by the patient
... item 0..* BackboneElement Product or service provided
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Item instance identifier
.... traceNumber 0..* Identifier Number for tracking
.... careTeamSequence 0..* positiveInt Applicable careTeam members
.... diagnosisSequence 0..* positiveInt Applicable diagnoses
.... procedureSequence 0..* positiveInt Applicable procedures
.... informationSequence 0..* positiveInt Applicable exception and supporting information
.... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
.... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
.... productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
.... productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Binding: USCLSCodes (example)
.... request 0..* Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription) Request or Referral for Service
.... modifier 0..* CodeableConcept Product or service billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
.... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
.... serviced[x] 0..1 Date or dates of service or product delivery
..... servicedDate date
..... servicedPeriod Period
.... location[x] 0..1 Place of service or where product was supplied
Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
..... locationCodeableConcept CodeableConcept
..... locationAddress Address
..... locationReference Reference(Location)
.... patientPaid 0..1 Money Paid by the patient
.... quantity 0..1 SimpleQuantity(5.0.0) Count of products or services
.... unitPrice 0..1 Money Fee, charge or cost per item
.... factor 0..1 decimal Price scaling factor
.... tax 0..1 Money Total tax
.... net 0..1 Money Total item cost
.... udi 0..* Reference(Device) Unique device identifier
.... bodySite 0..* BackboneElement Anatomical location
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... site 1..* CodeableReference(BodyStructure) Location
Binding: OralSiteCodes (example)
..... subSite 0..* CodeableConcept Sub-location
Binding: SurfaceCodes (example)
.... encounter 0..* Reference(Encounter) Encounters associated with the listed treatments
.... detail 0..* BackboneElement Product or service provided
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Item instance identifier
..... traceNumber 0..* Identifier Number for tracking
..... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
..... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
..... productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
..... productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Binding: USCLSCodes (example)
..... modifier 0..* CodeableConcept Service/Product billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
..... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
..... patientPaid 0..1 Money Paid by the patient
..... quantity 0..1 SimpleQuantity(5.0.0) Count of products or services
..... unitPrice 0..1 Money Fee, charge or cost per item
..... factor 0..1 decimal Price scaling factor
..... tax 0..1 Money Total tax
..... net 0..1 Money Total item cost
..... udi 0..* Reference(Device) Unique device identifier
..... subDetail 0..* BackboneElement Product or service provided
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... sequence 1..1 positiveInt Item instance identifier
...... traceNumber 0..* Identifier Number for tracking
...... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
...... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
...... productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
...... productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Binding: USCLSCodes (example)
...... modifier 0..* CodeableConcept Service/Product billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
...... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
...... patientPaid 0..1 Money Paid by the patient
...... quantity 0..1 SimpleQuantity(5.0.0) Count of products or services
...... unitPrice 0..1 Money Fee, charge or cost per item
...... factor 0..1 decimal Price scaling factor
...... tax 0..1 Money Total tax
...... net 0..1 Money Total item cost
...... udi 0..* Reference(Device) Unique device identifier
... total 0..1 Money Total claim cost

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Claim.language Base required All Languages 📍5.0.0 FHIR Std.
Claim.status Base required Financial Resource Status Codes 📍5.0.0 FHIR Std.
Claim.type Base extensible Claim Type Codes 📍5.0.0 FHIR Std.
Claim.subType Base example Example Claim SubType Codes 📍5.0.0 FHIR Std.
Claim.use Base required Use 📍5.0.0 FHIR Std.
Claim.priority Base example Process Priority Codes 📍5.0.0 FHIR Std.
Claim.fundsReserve Base example Funds Reservation Codes 📍5.0.0 FHIR Std.
Claim.related.relationship Base example Example Related Claim Relationship Codes 📍5.0.0 FHIR Std.
Claim.payee.type Base example Claim Payee Type Codes 📍5.0.0 FHIR Std.
Claim.diagnosisRelatedGroup Base example Example Diagnosis Related Group Codes 📍5.0.0 FHIR Std.
Claim.event.type Base example Dates Type Codes 📍5.0.0 FHIR Std.
Claim.careTeam.role Base example Claim Care Team Role Codes 📍5.0.0 FHIR Std.
Claim.careTeam.specialty Base example Example Provider Qualification Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo.​code Base example Exception Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo.​code.coding Base required MOPED VAESupportingInformationCategory 📦0.1.0 This IG
Claim.supportingInfo.​reason Base example Missing Tooth Reason Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Sonderklasse.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Sonderklasse.​code Base required Sonderklasse ValueSet 📦0.1.0 This IG
Claim.supportingInfo:Sonderklasse.​code.coding Base required MOPED VAESupportingInformationCategory 📦0.1.0 This IG
Claim.supportingInfo:Sonderklasse.​reason Base example Missing Tooth Reason Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:VerdachtFremdverschulden.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:VerdachtFremdverschulden.​code Base example Exception Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:VerdachtFremdverschulden.​code.coding Base required MOPED VAESupportingInformationCategory 📦0.1.0 This IG
Claim.supportingInfo:VerdachtFremdverschulden.​reason Base example Missing Tooth Reason Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Verlaengerungstage.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Verlaengerungstage.​code Base example Exception Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Verlaengerungstage.​code.coding Base required MOPED VAESupportingInformationCategory 📦0.1.0 This IG
Claim.supportingInfo:Verlaengerungstage.​value[x]:valueQuantity.​comparator Base required QuantityComparator 📍5.0.0 FHIR Std.
Claim.supportingInfo:Verlaengerungstage.​reason Base example Missing Tooth Reason Codes 📍5.0.0 FHIR Std.
Claim.diagnosis.type Base example Example Diagnosis Type Codes 📍5.0.0 FHIR Std.
Claim.diagnosis.onAdmission Base example Example Diagnosis on Admission Codes 📍5.0.0 FHIR Std.
Claim.procedure.type Base example Example Procedure Type Codes 📍5.0.0 FHIR Std.
Claim.procedure.procedure[x] Base example ICD-10 Procedure Codes 📍5.0.0 FHIR Std.
Claim.accident.type Base required Verdacht auf Arbeits- oder Schuelerunfall ValueSet 📦0.1.0 This IG
Claim.item.revenue Base example Example Revenue Center Codes 📍5.0.0 FHIR Std.
Claim.item.category Base example Benefit Category Codes 📍5.0.0 FHIR Std.
Claim.item.productOrService Base example USCLS Codes 📍5.0.0 FHIR Std.
Claim.item.productOrServiceEnd Base example USCLS Codes 📍5.0.0 FHIR Std.
Claim.item.modifier Base example Modifier type Codes 📍5.0.0 FHIR Std.
Claim.item.programCode Base example Example Program Reason Codes 📍5.0.0 FHIR Std.
Claim.item.location[x] Base example Example Service Place Codes 📍5.0.0 FHIR Std.
Claim.item.bodySite.​site Base example Oral Site Codes 📍5.0.0 FHIR Std.
Claim.item.bodySite.​subSite Base example Surface Codes 📍5.0.0 FHIR Std.
Claim.item.detail.revenue Base example Example Revenue Center Codes 📍5.0.0 FHIR Std.
Claim.item.detail.category Base example Benefit Category Codes 📍5.0.0 FHIR Std.
Claim.item.detail.productOrService Base example USCLS Codes 📍5.0.0 FHIR Std.
Claim.item.detail.productOrServiceEnd Base example USCLS Codes 📍5.0.0 FHIR Std.
Claim.item.detail.modifier Base example Modifier type Codes 📍5.0.0 FHIR Std.
Claim.item.detail.programCode Base example Example Program Reason Codes 📍5.0.0 FHIR Std.
Claim.item.detail.subDetail.​revenue Base example Example Revenue Center Codes 📍5.0.0 FHIR Std.
Claim.item.detail.subDetail.​category Base example Benefit Category Codes 📍5.0.0 FHIR Std.
Claim.item.detail.subDetail.​productOrService Base example USCLS Codes 📍5.0.0 FHIR Std.
Claim.item.detail.subDetail.​productOrServiceEnd Base example USCLS Codes 📍5.0.0 FHIR Std.
Claim.item.detail.subDetail.​modifier Base example Modifier type Codes 📍5.0.0 FHIR Std.
Claim.item.detail.subDetail.​programCode Base example Example Program Reason Codes 📍5.0.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Claim If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Claim 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 error Claim 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 error Claim If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Claim A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from Claim

Summary

Mandatory: 7 elements(5 nested mandatory elements)

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Claim.encounter
  • The element 1 is sliced based on the value of Claim.supportingInfo
  • The element 1 is sliced based on the value of Claim.supportingInfo.timing[x]
  • The element 1 is sliced based on the value of Claim.supportingInfo.value[x]

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim 0..* Claim Claim, Pre-determination or Pre-authorization
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... type OΣ 1..1 CodeableConcept Category or discipline
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
Required Pattern: At least the following
ObligationsActor
SHALL:populate Moped KH Actor
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: institutional
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... use OΣ 1..1 code claim | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
Required Pattern: preauthorization
ObligationsActor
SHALL:populate Moped KH Actor
... patient OΣ 1..1 Reference(HL7® AT Core Patient Profile) The recipient of the products and services
ObligationsActor
SHALL:handle Moped Device Actor
... created Σ 1..1 dateTime Resource creation date
... insurer OΣ 1..1 Reference(SV Organization) Target
ObligationsActor
SHALL:handle Moped Device Actor
... provider OΣ 1..1 Reference(KH Organization) Party responsible for the claim
ObligationsActor
SHALL:handle Moped Device Actor
... Slices for encounter 1..* Reference(Encounter) Encounters associated with the listed treatments
Slice: Unordered, Open by profile:resolve()
.... encounter:MopedEncounter O 1..1 Reference(MOPED Encounter) Generelle Informationen zu Aufnahme und Entlassung des Patienten
ObligationsActor
SHALL:handle Moped Device Actor
.... encounter:TransferEncounter O 0..* Reference(MOPED TransferEncounter) Informationen zu Verlegungen innerhalb oder zwischen Krankenanstalten
ObligationsActor
SHALL:handle Moped Device Actor
... Slices for supportingInfo 1..* BackboneElement Supporting information
Slice: Unordered, Open by value:category
.... supportingInfo:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
.... supportingInfo:Sonderklasse O 0..* BackboneElement KaOrg: Allgemeine Gebührenklasse/Sonderklasse
ObligationsActor
SHALL:populate Moped KH Actor
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: KLAS
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... code 1..1 CodeableConcept KaOrg: Verlegung Klasse
Binding: Sonderklasse ValueSet (required)
..... Slices for timing[x] 1..1 Period When it occurred
Slice: Unordered, Closed by type:$this
...... timing[x]:timingPeriod 1..1 Period KaOrg: Aufnahme-, Verlegungsdatum
.... supportingInfo:VerdachtFremdverschulden O 1..1 BackboneElement KaOrg: Fremdversschluden
ObligationsActor
SHALL:populate Moped KH Actor
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: FREVER
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... value[x] 1..1 boolean Data to be provided
.... supportingInfo:Verlaengerungstage O 0..1 BackboneElement KaOrg: Anzahl der Verlängerungstage
ObligationsActor
SHALL:populate Moped KH Actor
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: VERLAENG
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... Slices for value[x] 0..1 Data to be provided
Slice: Unordered, Open by type:$this
...... valueBoolean boolean
...... valueString string
...... valueQuantity Quantity
...... valueAttachment Attachment
...... valueReference Reference(Resource)
...... valueIdentifier Identifier
...... value[x]:valueQuantity 0..1 Quantity Data to be provided
....... value Σ 1..1 decimal Verlängerungstage
....... comparator ?!Σ 0..1 code < | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
....... unit Σ 0..1 string Unit representation
Required Pattern: day
....... system ΣC 0..1 uri System that defines coded unit form
Required Pattern: http://unitsofmeasure.org
....... code ΣC 0..1 code Coded form of the unit
Required Pattern: day

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Claim.status Base required Financial Resource Status Codes 📍5.0.0 FHIR Std.
Claim.type Base extensible Claim Type Codes 📍5.0.0 FHIR Std.
Claim.use Base required Use 📍5.0.0 FHIR Std.
Claim.supportingInfo.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Sonderklasse.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Sonderklasse.​code Base required Sonderklasse ValueSet 📦0.1.0 This IG
Claim.supportingInfo:VerdachtFremdverschulden.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Verlaengerungstage.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Verlaengerungstage.​value[x]:valueQuantity.​comparator Base required QuantityComparator 📍5.0.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Claim If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Claim 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 error Claim 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 error Claim If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Claim A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

This structure is derived from Claim

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim Claim
... status O 1..1 code active | cancelled | draft | entered-in-error
ObligationsActor
SHALL:handle Moped Device Actor
SHALL:populate Moped KH Actor
... type O 1..1 CodeableConcept Category or discipline
Required Pattern: At least the following
ObligationsActor
SHALL:populate Moped KH Actor
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: institutional
... use O 1..1 code claim | preauthorization | predetermination
Required Pattern: preauthorization
ObligationsActor
SHALL:populate Moped KH Actor
... insurer O 1..1 Reference(SV Organization) Target
ObligationsActor
SHALL:handle Moped Device Actor
... provider O 1..1 Reference(KH Organization) Party responsible for the claim
ObligationsActor
SHALL:handle Moped Device Actor
... related
.... claim O 0..1 Reference(MOPED VAERequest) Reference to the related claim
ObligationsActor
SHALL:populate Moped KH Actor
... Slices for encounter 1..* Reference(Encounter) Encounters associated with the listed treatments
Slice: Unordered, Open by profile:resolve()
.... encounter:MopedEncounter O 1..1 Reference(MOPED Encounter) Generelle Informationen zu Aufnahme und Entlassung des Patienten
ObligationsActor
SHALL:handle Moped Device Actor
.... encounter:TransferEncounter O 0..* Reference(MOPED TransferEncounter) Informationen zu Verlegungen innerhalb oder zwischen Krankenanstalten
ObligationsActor
SHALL:handle Moped Device Actor
... Slices for supportingInfo 1..* BackboneElement Supporting information
Slice: Unordered, Open by value:category
.... supportingInfo:All Slices Content/Rules for all slices
..... code
...... coding 0..* Coding Code defined by a terminology system
Binding: MOPED VAESupportingInformationCategory (required)
.... supportingInfo:Sonderklasse O 0..* BackboneElement KaOrg: Allgemeine Gebührenklasse/Sonderklasse
ObligationsActor
SHALL:populate Moped KH Actor
..... category 1..1 CodeableConcept Classification of the supplied information
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: KLAS
..... code 1..1 CodeableConcept KaOrg: Verlegung Klasse
Binding: Sonderklasse ValueSet (required)
..... Slices for timing[x] 1..1 Period When it occurred
Slice: Unordered, Open by type:$this
...... timing[x]:timingPeriod 1..1 Period KaOrg: Aufnahme-, Verlegungsdatum
.... supportingInfo:VerdachtFremdverschulden O 1..1 BackboneElement KaOrg: Fremdversschluden
ObligationsActor
SHALL:populate Moped KH Actor
..... category 1..1 CodeableConcept Classification of the supplied information
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: FREVER
..... value[x] 1..1 boolean Data to be provided
.... supportingInfo:Verlaengerungstage O 0..1 BackboneElement KaOrg: Anzahl der Verlängerungstage
ObligationsActor
SHALL:populate Moped KH Actor
..... category 1..1 CodeableConcept Classification of the supplied information
Required Pattern: At least the following
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: VERLAENG
..... Slices for value[x] 0..1 boolean, string, Quantity, Attachment, Reference(Resource), Identifier Data to be provided
Slice: Unordered, Open by type:$this
...... value[x]:valueQuantity 0..1 Quantity Data to be provided
....... value 1..1 decimal Verlängerungstage
....... unit 0..1 string Unit representation
Required Pattern: day
....... system 0..1 uri System that defines coded unit form
Required Pattern: http://unitsofmeasure.org
....... code 0..1 code Coded form of the unit
Required Pattern: day
... diagnosis
.... diagnosis[x] O 1..1 Reference(MOPED Condition) Nature of illness or problem
ObligationsActor
SHALL:populate Moped KH Actor
... insurance
.... coverage O 1..1 Reference(MOPED Coverage) Insurance information
ObligationsActor
SHALL:handle Moped Device Actor
... accident
.... date O 1..1 date KaOrg: Ereignis-/Unfalldatum (echtes Unfalldatum)
ObligationsActor
SHALL:populate Moped KH Actor
.... type O 1..1 CodeableConcept KaOrg: Verdacht auf Arbeits-/Schülerunfall
Binding: Verdacht auf Arbeits- oder Schuelerunfall ValueSet (required)
ObligationsActor
SHALL:populate Moped KH Actor

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Claim.supportingInfo.​code.coding Base required MOPED VAESupportingInformationCategory 📦0.1.0 This IG
Claim.supportingInfo:Sonderklasse.​code Base required Sonderklasse ValueSet 📦0.1.0 This IG
Claim.accident.type Base required Verdacht auf Arbeits- oder Schuelerunfall ValueSet 📦0.1.0 This IG

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim 0..* Claim Claim, Pre-determination or Pre-authorization
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: AllLanguages (required): IETF language tag for a human language
Additional BindingsPurpose
CommonLanguages Starter
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier Business Identifier for claim
... traceNumber 0..* Identifier Number for tracking
... status ?!OΣ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
ObligationsActor
SHALL:handle Moped Device Actor
SHALL:populate Moped KH Actor
... type OΣ 1..1 CodeableConcept Category or discipline
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
Required Pattern: At least the following
ObligationsActor
SHALL:populate Moped KH Actor
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: institutional
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subType 0..1 CodeableConcept More granular claim type
Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode.
... use OΣ 1..1 code claim | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
Required Pattern: preauthorization
ObligationsActor
SHALL:populate Moped KH Actor
... patient OΣ 1..1 Reference(HL7® AT Core Patient Profile) The recipient of the products and services
ObligationsActor
SHALL:handle Moped Device Actor
... billablePeriod Σ 0..1 Period Relevant time frame for the claim
... created Σ 1..1 dateTime Resource creation date
... enterer 0..1 Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) Author of the claim
... insurer OΣ 1..1 Reference(SV Organization) Target
ObligationsActor
SHALL:handle Moped Device Actor
... provider OΣ 1..1 Reference(KH Organization) Party responsible for the claim
ObligationsActor
SHALL:handle Moped Device Actor
... priority Σ 0..1 CodeableConcept Desired processing urgency
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
... fundsReserve 0..1 CodeableConcept For whom to reserve funds
Binding: FundsReservationCodes (example): For whom funds are to be reserved: (Patient, Provider, None).
... related 0..* BackboneElement Prior or corollary claims
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... claim O 0..1 Reference(MOPED VAERequest) Reference to the related claim
ObligationsActor
SHALL:populate Moped KH Actor
.... relationship 0..1 CodeableConcept How the reference claim is related
Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.
.... reference 0..1 Identifier File or case reference
... prescription 0..1 Reference(DeviceRequest | MedicationRequest | VisionPrescription) Prescription authorizing services and products
... originalPrescription 0..1 Reference(DeviceRequest | MedicationRequest | VisionPrescription) Original prescription if superseded by fulfiller
... payee 0..1 BackboneElement Recipient of benefits payable
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 CodeableConcept Category of recipient
Binding: ClaimPayeeTypeCodes (example): A code for the party to be reimbursed.
.... party 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson) Recipient reference
... referral 0..1 Reference(ServiceRequest) Treatment referral
... Slices for encounter 1..* Reference(Encounter) Encounters associated with the listed treatments
Slice: Unordered, Open by profile:resolve()
.... encounter:MopedEncounter O 1..1 Reference(MOPED Encounter) Generelle Informationen zu Aufnahme und Entlassung des Patienten
ObligationsActor
SHALL:handle Moped Device Actor
.... encounter:TransferEncounter O 0..* Reference(MOPED TransferEncounter) Informationen zu Verlegungen innerhalb oder zwischen Krankenanstalten
ObligationsActor
SHALL:handle Moped Device Actor
... facility 0..1 Reference(Location | Organization) Servicing facility
... diagnosisRelatedGroup 0..1 CodeableConcept Package billing code
Binding: ExampleDiagnosisRelatedGroupCodes (example)
... event 0..* BackboneElement Event information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 CodeableConcept Specific event
Binding: DatesTypeCodes (example)
.... when[x] 1..1 Occurance date or period
..... whenDateTime dateTime
..... whenPeriod Period
... careTeam 0..* BackboneElement Members of the care team
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Order of care team
.... provider 1..1 Reference(Practitioner | PractitionerRole | Organization) Practitioner or organization
.... responsible 0..1 boolean Indicator of the lead practitioner
.... role 0..1 CodeableConcept Function within the team
Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.
.... specialty 0..1 CodeableConcept Practitioner or provider specialization
Binding: ExampleProviderQualificationCodes (example)
... Slices for supportingInfo 1..* BackboneElement Supporting information
Slice: Unordered, Open by value:category
.... supportingInfo:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
..... code 0..1 CodeableConcept Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
Binding: MOPED VAESupportingInformationCategory (required)
...... text Σ 0..1 string Plain text representation of the concept
..... timing[x] 0..1 When it occurred
...... timingDate date
...... timingPeriod Period
..... value[x] 0..1 Data to be provided
...... valueBoolean boolean
...... valueString string
...... valueQuantity Quantity
...... valueAttachment Attachment
...... valueReference Reference(Resource)
...... valueIdentifier Identifier
..... reason 0..1 CodeableConcept Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
.... supportingInfo:Sonderklasse O 0..* BackboneElement KaOrg: Allgemeine Gebührenklasse/Sonderklasse
ObligationsActor
SHALL:populate Moped KH Actor
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: KLAS
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... code 1..1 CodeableConcept KaOrg: Verlegung Klasse
Binding: Sonderklasse ValueSet (required)
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
Binding: MOPED VAESupportingInformationCategory (required)
...... text Σ 0..1 string Plain text representation of the concept
..... Slices for timing[x] 1..1 Period When it occurred
Slice: Unordered, Closed by type:$this
...... timing[x]:timingPeriod 1..1 Period KaOrg: Aufnahme-, Verlegungsdatum
..... value[x] 0..1 Data to be provided
...... valueBoolean boolean
...... valueString string
...... valueQuantity Quantity
...... valueAttachment Attachment
...... valueReference Reference(Resource)
...... valueIdentifier Identifier
..... reason 0..1 CodeableConcept Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
.... supportingInfo:VerdachtFremdverschulden O 1..1 BackboneElement KaOrg: Fremdversschluden
ObligationsActor
SHALL:populate Moped KH Actor
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: FREVER
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... code 0..1 CodeableConcept Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
Binding: MOPED VAESupportingInformationCategory (required)
...... text Σ 0..1 string Plain text representation of the concept
..... timing[x] 0..1 When it occurred
...... timingDate date
...... timingPeriod Period
..... value[x] 1..1 boolean Data to be provided
..... reason 0..1 CodeableConcept Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
.... supportingInfo:Verlaengerungstage O 0..1 BackboneElement KaOrg: Anzahl der Verlängerungstage
ObligationsActor
SHALL:populate Moped KH Actor
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
Required Pattern: At least the following
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
....... system 1..1 uri Identity of the terminology system
Fixed Value: https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: VERLAENG
....... display 0..1 string Representation defined by the system
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... code 0..1 CodeableConcept Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ 0..* Coding Code defined by a terminology system
Binding: MOPED VAESupportingInformationCategory (required)
...... text Σ 0..1 string Plain text representation of the concept
..... timing[x] 0..1 When it occurred
...... timingDate date
...... timingPeriod Period
..... Slices for value[x] 0..1 Data to be provided
Slice: Unordered, Open by type:$this
...... valueBoolean boolean
...... valueString string
...... valueQuantity Quantity
...... valueAttachment Attachment
...... valueReference Reference(Resource)
...... valueIdentifier Identifier
...... value[x]:valueQuantity 0..1 Quantity Data to be provided
....... id 0..1 id Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... value Σ 1..1 decimal Verlängerungstage
....... comparator ?!Σ 0..1 code < | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
....... unit Σ 0..1 string Unit representation
Required Pattern: day
....... system ΣC 0..1 uri System that defines coded unit form
Required Pattern: http://unitsofmeasure.org
....... code ΣC 0..1 code Coded form of the unit
Required Pattern: day
..... reason 0..1 CodeableConcept Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
... diagnosis 0..* BackboneElement Pertinent diagnosis information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Diagnosis instance identifier
.... diagnosis[x] O 1..1 Reference(MOPED Condition) Nature of illness or problem
ObligationsActor
SHALL:populate Moped KH Actor
.... type 0..* CodeableConcept Timing or nature of the diagnosis
Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
.... onAdmission 0..1 CodeableConcept Present on admission
Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
... procedure 0..* BackboneElement Clinical procedures performed
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Procedure instance identifier
.... type 0..* CodeableConcept Category of Procedure
Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
.... date 0..1 dateTime When the procedure was performed
.... procedure[x] 1..1 Specific clinical procedure
Binding: ICD10ProcedureCodes (example): Example ICD10 Procedure codes.
..... procedureCodeableConcept CodeableConcept
..... procedureReference Reference(Procedure)
.... udi 0..* Reference(Device) Unique device identifier
... insurance Σ 0..* BackboneElement Patient insurance information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 1..1 positiveInt Insurance instance identifier
.... focal Σ 1..1 boolean Coverage to be used for adjudication
.... identifier 0..1 Identifier Pre-assigned Claim number
.... coverage OΣ 1..1 Reference(MOPED Coverage) Insurance information
ObligationsActor
SHALL:handle Moped Device Actor
.... businessArrangement 0..1 string Additional provider contract number
.... preAuthRef 0..* string Prior authorization reference number
.... claimResponse 0..1 Reference(ClaimResponse) Adjudication results
... accident 0..1 BackboneElement Details of the event
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... date O 1..1 date KaOrg: Ereignis-/Unfalldatum (echtes Unfalldatum)
ObligationsActor
SHALL:populate Moped KH Actor
.... type O 1..1 CodeableConcept KaOrg: Verdacht auf Arbeits-/Schülerunfall
Binding: Verdacht auf Arbeits- oder Schuelerunfall ValueSet (required)
ObligationsActor
SHALL:populate Moped KH Actor
.... location[x] 0..1 Where the event occurred
..... locationAddress Address
..... locationReference Reference(Location)
... patientPaid 0..1 Money Paid by the patient
... item 0..* BackboneElement Product or service provided
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Item instance identifier
.... traceNumber 0..* Identifier Number for tracking
.... careTeamSequence 0..* positiveInt Applicable careTeam members
.... diagnosisSequence 0..* positiveInt Applicable diagnoses
.... procedureSequence 0..* positiveInt Applicable procedures
.... informationSequence 0..* positiveInt Applicable exception and supporting information
.... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
.... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
.... productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
.... productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Binding: USCLSCodes (example)
.... request 0..* Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription) Request or Referral for Service
.... modifier 0..* CodeableConcept Product or service billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
.... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
.... serviced[x] 0..1 Date or dates of service or product delivery
..... servicedDate date
..... servicedPeriod Period
.... location[x] 0..1 Place of service or where product was supplied
Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
..... locationCodeableConcept CodeableConcept
..... locationAddress Address
..... locationReference Reference(Location)
.... patientPaid 0..1 Money Paid by the patient
.... quantity 0..1 SimpleQuantity(5.0.0) Count of products or services
.... unitPrice 0..1 Money Fee, charge or cost per item
.... factor 0..1 decimal Price scaling factor
.... tax 0..1 Money Total tax
.... net 0..1 Money Total item cost
.... udi 0..* Reference(Device) Unique device identifier
.... bodySite 0..* BackboneElement Anatomical location
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... site 1..* CodeableReference(BodyStructure) Location
Binding: OralSiteCodes (example)
..... subSite 0..* CodeableConcept Sub-location
Binding: SurfaceCodes (example)
.... encounter 0..* Reference(Encounter) Encounters associated with the listed treatments
.... detail 0..* BackboneElement Product or service provided
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Item instance identifier
..... traceNumber 0..* Identifier Number for tracking
..... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
..... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
..... productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
..... productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Binding: USCLSCodes (example)
..... modifier 0..* CodeableConcept Service/Product billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
..... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
..... patientPaid 0..1 Money Paid by the patient
..... quantity 0..1 SimpleQuantity(5.0.0) Count of products or services
..... unitPrice 0..1 Money Fee, charge or cost per item
..... factor 0..1 decimal Price scaling factor
..... tax 0..1 Money Total tax
..... net 0..1 Money Total item cost
..... udi 0..* Reference(Device) Unique device identifier
..... subDetail 0..* BackboneElement Product or service provided
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... sequence 1..1 positiveInt Item instance identifier
...... traceNumber 0..* Identifier Number for tracking
...... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
...... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
...... productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
...... productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Binding: USCLSCodes (example)
...... modifier 0..* CodeableConcept Service/Product billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
...... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
...... patientPaid 0..1 Money Paid by the patient
...... quantity 0..1 SimpleQuantity(5.0.0) Count of products or services
...... unitPrice 0..1 Money Fee, charge or cost per item
...... factor 0..1 decimal Price scaling factor
...... tax 0..1 Money Total tax
...... net 0..1 Money Total item cost
...... udi 0..* Reference(Device) Unique device identifier
... total 0..1 Money Total claim cost

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Claim.language Base required All Languages 📍5.0.0 FHIR Std.
Claim.status Base required Financial Resource Status Codes 📍5.0.0 FHIR Std.
Claim.type Base extensible Claim Type Codes 📍5.0.0 FHIR Std.
Claim.subType Base example Example Claim SubType Codes 📍5.0.0 FHIR Std.
Claim.use Base required Use 📍5.0.0 FHIR Std.
Claim.priority Base example Process Priority Codes 📍5.0.0 FHIR Std.
Claim.fundsReserve Base example Funds Reservation Codes 📍5.0.0 FHIR Std.
Claim.related.relationship Base example Example Related Claim Relationship Codes 📍5.0.0 FHIR Std.
Claim.payee.type Base example Claim Payee Type Codes 📍5.0.0 FHIR Std.
Claim.diagnosisRelatedGroup Base example Example Diagnosis Related Group Codes 📍5.0.0 FHIR Std.
Claim.event.type Base example Dates Type Codes 📍5.0.0 FHIR Std.
Claim.careTeam.role Base example Claim Care Team Role Codes 📍5.0.0 FHIR Std.
Claim.careTeam.specialty Base example Example Provider Qualification Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo.​code Base example Exception Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo.​code.coding Base required MOPED VAESupportingInformationCategory 📦0.1.0 This IG
Claim.supportingInfo.​reason Base example Missing Tooth Reason Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Sonderklasse.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Sonderklasse.​code Base required Sonderklasse ValueSet 📦0.1.0 This IG
Claim.supportingInfo:Sonderklasse.​code.coding Base required MOPED VAESupportingInformationCategory 📦0.1.0 This IG
Claim.supportingInfo:Sonderklasse.​reason Base example Missing Tooth Reason Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:VerdachtFremdverschulden.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:VerdachtFremdverschulden.​code Base example Exception Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:VerdachtFremdverschulden.​code.coding Base required MOPED VAESupportingInformationCategory 📦0.1.0 This IG
Claim.supportingInfo:VerdachtFremdverschulden.​reason Base example Missing Tooth Reason Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Verlaengerungstage.​category Base example Claim Information Category Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Verlaengerungstage.​code Base example Exception Codes 📍5.0.0 FHIR Std.
Claim.supportingInfo:Verlaengerungstage.​code.coding Base required MOPED VAESupportingInformationCategory 📦0.1.0 This IG
Claim.supportingInfo:Verlaengerungstage.​value[x]:valueQuantity.​comparator Base required QuantityComparator 📍5.0.0 FHIR Std.
Claim.supportingInfo:Verlaengerungstage.​reason Base example Missing Tooth Reason Codes 📍5.0.0 FHIR Std.
Claim.diagnosis.type Base example Example Diagnosis Type Codes 📍5.0.0 FHIR Std.
Claim.diagnosis.onAdmission Base example Example Diagnosis on Admission Codes 📍5.0.0 FHIR Std.
Claim.procedure.type Base example Example Procedure Type Codes 📍5.0.0 FHIR Std.
Claim.procedure.procedure[x] Base example ICD-10 Procedure Codes 📍5.0.0 FHIR Std.
Claim.accident.type Base required Verdacht auf Arbeits- oder Schuelerunfall ValueSet 📦0.1.0 This IG
Claim.item.revenue Base example Example Revenue Center Codes 📍5.0.0 FHIR Std.
Claim.item.category Base example Benefit Category Codes 📍5.0.0 FHIR Std.
Claim.item.productOrService Base example USCLS Codes 📍5.0.0 FHIR Std.
Claim.item.productOrServiceEnd Base example USCLS Codes 📍5.0.0 FHIR Std.
Claim.item.modifier Base example Modifier type Codes 📍5.0.0 FHIR Std.
Claim.item.programCode Base example Example Program Reason Codes 📍5.0.0 FHIR Std.
Claim.item.location[x] Base example Example Service Place Codes 📍5.0.0 FHIR Std.
Claim.item.bodySite.​site Base example Oral Site Codes 📍5.0.0 FHIR Std.
Claim.item.bodySite.​subSite Base example Surface Codes 📍5.0.0 FHIR Std.
Claim.item.detail.revenue Base example Example Revenue Center Codes 📍5.0.0 FHIR Std.
Claim.item.detail.category Base example Benefit Category Codes 📍5.0.0 FHIR Std.
Claim.item.detail.productOrService Base example USCLS Codes 📍5.0.0 FHIR Std.
Claim.item.detail.productOrServiceEnd Base example USCLS Codes 📍5.0.0 FHIR Std.
Claim.item.detail.modifier Base example Modifier type Codes 📍5.0.0 FHIR Std.
Claim.item.detail.programCode Base example Example Program Reason Codes 📍5.0.0 FHIR Std.
Claim.item.detail.subDetail.​revenue Base example Example Revenue Center Codes 📍5.0.0 FHIR Std.
Claim.item.detail.subDetail.​category Base example Benefit Category Codes 📍5.0.0 FHIR Std.
Claim.item.detail.subDetail.​productOrService Base example USCLS Codes 📍5.0.0 FHIR Std.
Claim.item.detail.subDetail.​productOrServiceEnd Base example USCLS Codes 📍5.0.0 FHIR Std.
Claim.item.detail.subDetail.​modifier Base example Modifier type Codes 📍5.0.0 FHIR Std.
Claim.item.detail.subDetail.​programCode Base example Example Program Reason Codes 📍5.0.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Claim If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Claim 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 error Claim 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 error Claim If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Claim A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from Claim

Summary

Mandatory: 7 elements(5 nested mandatory elements)

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Claim.encounter
  • The element 1 is sliced based on the value of Claim.supportingInfo
  • The element 1 is sliced based on the value of Claim.supportingInfo.timing[x]
  • The element 1 is sliced based on the value of Claim.supportingInfo.value[x]

 

Other representations of profile: CSV, Excel, Schematron