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

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

Resource Profile: MopedLKFRequest - Detailed Descriptions

Draft as of 2025-09-11

Definitions for the MopedLKFRequest resource profile.

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

0. Claim
Definition

A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.

ShortClaim, Pre-determination or Pre-authorization
Comments

The Claim resource fulfills three information request requirements: Claim - a request for adjudication for reimbursement for products and/or services provided; Preauthorization - a request to authorize the future provision of products and/or services including an anticipated adjudication; and, Predetermination - a request for a non-bind adjudication of possible future products and/or services.

Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate NamesAdjudication Request, Preauthorization Request, Predetermination Request
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Claim.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

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

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

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

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control20..*
TypeExtension
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Claim.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. Claim.extension:DiagnoseKnoten
    Slice NameDiagnoseKnoten
    Definition

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

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

    MOPED Extension für akzeptierte Errors und Warnings

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

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

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

    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

    The status of the resource instance.

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

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

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

    A code specifying the state of the resource instance.

    Typecode
    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Requirements

    Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.

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

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

    ShortCategory or discipline
    Comments

    The code system provides oral, pharmacy, vision, professional and institutional claim types. Those supported depends on the requirements of the jurisdiction. The valueset is extensible to accommodate other types of claims as required by the jurisdiction.

    Control1..1
    BindingUnless not suitable, these codes SHALL be taken from ClaimTypeCodeshttp://hl7.org/fhir/ValueSet/claim-type|5.0.0
    (extensible to http://hl7.org/fhir/ValueSet/claim-type|5.0.0)

    The type or discipline-style of the claim.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Requirements

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

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

    A code to indicate whether the nature of the request is: Claim - A request to an Insurer to adjudicate the supplied charges for health care goods and services under the identified policy and to pay the determined Benefit amount, if any; Preauthorization - A request to an Insurer to adjudicate the supplied proposed future charges for health care goods and services under the identified policy and to approve the services and provide the expected benefit amounts and potentially to reserve funds to pay the benefits when Claims for the indicated services are later submitted; or, Pre-determination - A request to an Insurer to adjudicate the supplied 'what if' charges for health care goods and services under the identified policy and report back what the Benefit payable would be had the services actually been provided.

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

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

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

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

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

    The party to whom the professional services and/or products have been supplied or are being considered and for whom actual or forecast reimbursement is sought.

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

    The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction.

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

    The date this resource was created.

    ShortResource creation date
    Comments

    This field is independent of the date of creation of the resource as it may reflect the creation date of a source document prior to digitization. Typically for claims all services must be completed as of this date.

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

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

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

    The Insurer who is target of the request.

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

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

    ShortParty responsible for the claim
    Comments

    Typically this field would be 1..1 where this party is accountable for the data content within the claim but is not necessarily the facility, provider group or practitioner who provided the products and services listed within this claim resource. This field is the Billing Provider, for example, a facility, provider group, lab or practitioner.

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

    Healthcare encounters related to this claim.

    ShortEncounters associated with the listed treatments
    Comments

    This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

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

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

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

      Healthcare encounters related to this claim.

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

      This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

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

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

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

      Healthcare encounters related to this claim.

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

      This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

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

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

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

      A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.

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

      For example DRG (Diagnosis Related Group) or a bundled billing code. A patient may have a diagnosis of a Myocardial Infarction and a DRG for HeartAttack would be assigned. The Claim item (and possible subsequent claims) would refer to the DRG for those line items that were for services related to the heart attack event.

      Control10..1
      BindingThe codes SHALL be taken from For example codes, see LKF Abrechnungsgruppehttp://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup|5.0.0
      (required to https://elga.moped.at/ValueSet/LKFAbrechnungsGruppeVS)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Requirements

      Required to relate the current diagnosis to a package billing code that is then referenced on the individual claim items which are specific to the health condition covered by the package code.

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

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

      ShortSupporting information
      Comments

      Often there are multiple jurisdiction specific valuesets which are required.

      Control20..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Requirements

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

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

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

        A number to uniquely identify supporting information entries.

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

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

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

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

        ShortClassification of the supplied information
        Comments

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

        Control1..1
        BindingFor example codes, see ClaimInformationCategoryCodeshttp://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0
        (example to http://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0)

        The valuset used for additional information category codes.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Requirements

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

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

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

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

        Often there are multiple jurisdiction specific valuesets which are required.

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

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

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

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

        A number to uniquely identify supporting information entries.

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

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

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

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

        ShortClassification of the supplied information
        Comments

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

        Control1..1
        BindingFor example codes, see ClaimInformationCategoryCodeshttp://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0
        (example to http://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0)

        The valuset used for additional information category codes.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Requirements

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

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

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

        ShortData to be provided
        Comments

        Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.

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

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

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

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

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

        Often there are multiple jurisdiction specific valuesets which are required.

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

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

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

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

        A number to uniquely identify supporting information entries.

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

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

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

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

        ShortClassification of the supplied information
        Comments

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

        Control1..1
        BindingFor example codes, see ClaimInformationCategoryCodeshttp://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0
        (example to http://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0)

        The valuset used for additional information category codes.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Requirements

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

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

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

        ShortData to be provided
        Comments

        Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.

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

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

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

        A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

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

        The items to be processed for adjudication.

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

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

          A number to uniquely identify item entries.

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

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

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

          A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

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

          The items to be processed for adjudication.

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

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

          A number to uniquely identify item entries.

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

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

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

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

          ShortBenefit classification
          Comments

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

          Control0..1
          BindingThe codes SHALL be taken from For example codes, see Moped Claim Item Category ValueSethttp://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0
          (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Requirements

          Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

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

          A reference to a code defined by a terminology system.

          ShortCode defined by a terminology system
          Comments

          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

          Control10..*
          TypeCoding
          Is Modifierfalse
          Summarytrue
          Requirements

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

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

          The number of repetitions of a service or product.

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

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

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

          Not allowed to be used in this context


          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

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

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

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

          A human-readable form of the unit.

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

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

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

          A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

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

          The items to be processed for adjudication.

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

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

          A number to uniquely identify item entries.

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

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

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

          The number of repetitions of a service or product.

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

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

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

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

          ShortNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

          Precision is handled implicitly in almost all cases of measurement.

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

          Not allowed to be used in this context


          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

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

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

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

          A human-readable form of the unit.

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

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

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

          A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

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

          The items to be processed for adjudication.

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

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

          A number to uniquely identify item entries.

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

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

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

          The number of repetitions of a service or product.

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

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

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

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

          ShortNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

          Precision is handled implicitly in almost all cases of measurement.

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

          Not allowed to be used in this context


          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

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

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

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

          A human-readable form of the unit.

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

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

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

          A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

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

          The items to be processed for adjudication.

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

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

          A number to uniquely identify item entries.

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

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

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

          The number of repetitions of a service or product.

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

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

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

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

          ShortNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

          Precision is handled implicitly in almost all cases of measurement.

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

          Not allowed to be used in this context


          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

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

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

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

          A human-readable form of the unit.

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

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

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

          A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

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

          The items to be processed for adjudication.

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

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

          A number to uniquely identify item entries.

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

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

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

          The number of repetitions of a service or product.

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

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

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

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

          ShortNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

          Precision is handled implicitly in almost all cases of measurement.

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

          Not allowed to be used in this context


          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

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

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

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

          A human-readable form of the unit.

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

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

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

          A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

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

          The items to be processed for adjudication.

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

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

          A number to uniquely identify item entries.

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

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

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

          The number of repetitions of a service or product.

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

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

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

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

          ShortNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

          Precision is handled implicitly in almost all cases of measurement.

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

          Not allowed to be used in this context


          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

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

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

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

          A human-readable form of the unit.

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

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

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

          A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

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

          The items to be processed for adjudication.

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

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

          A number to uniquely identify item entries.

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

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

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

          The number of repetitions of a service or product.

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

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

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

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

          ShortNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

          Precision is handled implicitly in almost all cases of measurement.

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

          Not allowed to be used in this context


          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

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

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

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

          A human-readable form of the unit.

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

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

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

          A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

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

          The items to be processed for adjudication.

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

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

          A number to uniquely identify item entries.

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

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

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

          The number of repetitions of a service or product.

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

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

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

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

          ShortNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

          Precision is handled implicitly in almost all cases of measurement.

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

          Not allowed to be used in this context


          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

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

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

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

          A human-readable form of the unit.

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

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

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

          A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

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

          The items to be processed for adjudication.

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

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

          A number to uniquely identify item entries.

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

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

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

          The number of repetitions of a service or product.

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

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

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

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

          ShortNumerical value (with implicit precision)
          Comments

          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

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

          Precision is handled implicitly in almost all cases of measurement.

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

          Not allowed to be used in this context


          How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

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

          How the Quantity should be understood and represented.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

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

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

          A human-readable form of the unit.

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

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

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

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

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

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

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

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

                    0. Claim
                    Definition

                    A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.

                    ShortClaim, Pre-determination or Pre-authorization
                    Comments

                    The Claim resource fulfills three information request requirements: Claim - a request for adjudication for reimbursement for products and/or services provided; Preauthorization - a request to authorize the future provision of products and/or services including an anticipated adjudication; and, Predetermination - a request for a non-bind adjudication of possible future products and/or services.

                    Control0..*
                    Is Modifierfalse
                    Must Supportfalse
                    Summaryfalse
                    Alternate NamesAdjudication Request, Preauthorization Request, Predetermination Request
                    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                    dom-6: A resource should have narrative for robust management (text.`div`.exists())
                    2. Claim.id
                    Definition

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

                    ShortLogical id of this artifact
                    Comments

                    Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

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

                    The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

                    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                    ShortA set of rules under which this content was created
                    Comments

                    Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

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

                    The base language in which the resource is written.

                    ShortLanguage of the resource content
                    Comments

                    Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

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

                    IETF language tag for a human language

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

                    A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                    ShortText summary of the resource, for human interpretation
                    Comments

                    Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

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

                    These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

                    ShortContained, inline Resources
                    Comments

                    This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

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

                    An Extension

                    ShortExtension
                    Control2..*
                    TypeExtension
                    Is Modifierfalse
                    Must Supportfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on Claim.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 16. Claim.extension:DiagnoseKnoten
                      Slice NameDiagnoseKnoten
                      Definition

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

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

                      MOPED Extension für akzeptierte Errors und Warnings

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

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

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

                      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                      ShortExtensions that cannot be ignored
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

                      A unique identifier assigned to this claim.

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

                      Allows claims to be distinguished and referenced.

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

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

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

                      Allows partners to uniquely identify components for tracking.

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

                      The status of the resource instance.

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

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

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

                      A code specifying the state of the resource instance.

                      Typecode
                      Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supportfalse
                      Summarytrue
                      Requirements

                      Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.

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

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

                      ShortCategory or discipline
                      Comments

                      The code system provides oral, pharmacy, vision, professional and institutional claim types. Those supported depends on the requirements of the jurisdiction. The valueset is extensible to accommodate other types of claims as required by the jurisdiction.

                      Control1..1
                      BindingUnless not suitable, these codes SHALL be taken from ClaimTypeCodes
                      (extensible to http://hl7.org/fhir/ValueSet/claim-type|5.0.0)

                      The type or discipline-style of the claim.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Requirements

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

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

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

                      ShortMore granular claim type
                      Comments

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

                      Control0..1
                      BindingFor example codes, see ExampleClaimSubTypeCodes
                      (example to http://hl7.org/fhir/ValueSet/claim-subtype|5.0.0)

                      A more granular claim typecode.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Requirements

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

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

                      A code to indicate whether the nature of the request is: Claim - A request to an Insurer to adjudicate the supplied charges for health care goods and services under the identified policy and to pay the determined Benefit amount, if any; Preauthorization - A request to an Insurer to adjudicate the supplied proposed future charges for health care goods and services under the identified policy and to approve the services and provide the expected benefit amounts and potentially to reserve funds to pay the benefits when Claims for the indicated services are later submitted; or, Pre-determination - A request to an Insurer to adjudicate the supplied 'what if' charges for health care goods and services under the identified policy and report back what the Benefit payable would be had the services actually been provided.

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

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

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

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

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

                      The party to whom the professional services and/or products have been supplied or are being considered and for whom actual or forecast reimbursement is sought.

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

                      The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction.

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

                      The period for which charges are being submitted.

                      ShortRelevant time frame for the claim
                      Comments

                      Typically this would be today or in the past for a claim, and today or in the future for preauthorizations and predeterminations. Typically line item dates of service should fall within the billing period if one is specified.

                      Control0..1
                      TypePeriod
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Requirements

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

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

                      The date this resource was created.

                      ShortResource creation date
                      Comments

                      This field is independent of the date of creation of the resource as it may reflect the creation date of a source document prior to digitization. Typically for claims all services must be completed as of this date.

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

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

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

                      Individual who created the claim, predetermination or preauthorization.

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

                      Some jurisdictions require the contact information for personnel completing claims.

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

                      The Insurer who is target of the request.

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

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

                      ShortParty responsible for the claim
                      Comments

                      Typically this field would be 1..1 where this party is accountable for the data content within the claim but is not necessarily the facility, provider group or practitioner who provided the products and services listed within this claim resource. This field is the Billing Provider, for example, a facility, provider group, lab or practitioner.

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

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

                      ShortDesired processing urgency
                      Comments

                      If a claim processor is unable to complete the processing as per the priority then they should generate an error and not process the request.

                      Control0..1
                      BindingFor example codes, see ProcessPriorityCodes
                      (example to http://hl7.org/fhir/ValueSet/process-priority|5.0.0)

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

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Requirements

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

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

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

                      ShortFor whom to reserve funds
                      Comments

                      This field is only used for preauthorizations.

                      Control0..1
                      BindingFor example codes, see FundsReservationCodes
                      (example to http://hl7.org/fhir/ValueSet/fundsreserve|5.0.0)

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

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Requirements

                      In the case of a Pre-Determination/Pre-Authorization the provider may request that funds in the amount of the expected Benefit be reserved ('Patient' or 'Provider') to pay for the Benefits determined on the subsequent claim(s). 'None' explicitly indicates no funds reserving is requested.

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

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

                      ShortPrior or corollary claims
                      Comments

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

                      Control0..*
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Requirements

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

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

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

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

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                      ShortExtensions that cannot be ignored even if unrecognized
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

                      Reference to a related claim.

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

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

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

                      A code to convey how the claims are related.

                      ShortHow the reference claim is related
                      Comments

                      For example, prior claim or umbrella.

                      Control0..1
                      BindingFor example codes, see ExampleRelatedClaimRelationshipCodes
                      (example to http://hl7.org/fhir/ValueSet/related-claim-relationship|5.0.0)

                      Relationship of this claim to a related Claim.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Requirements

                      Some insurers need a declaration of the type of relationship.

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

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

                      ShortFile or case reference
                      Comments

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

                      Control0..1
                      TypeIdentifier
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Requirements

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

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

                      Prescription is the document/authorization given to the claim author for them to provide products and services for which consideration (reimbursement) is sought. Could be a RX for medications, an 'order' for oxygen or wheelchair or physiotherapy treatments.

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

                      Required to authorize the dispensing of controlled substances and devices.

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

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

                      ShortOriginal prescription if superseded by fulfiller
                      Comments

                      For example, a physician may prescribe a medication which the pharmacy determines is contraindicated, or for which the patient has an intolerance, and therefore issues a new prescription for an alternate medication which has the same therapeutic intent. The prescription from the pharmacy becomes the 'prescription' and that from the physician becomes the 'original prescription'.

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

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

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

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

                      ShortRecipient of benefits payable
                      Comments

                      Often providers agree to receive the benefits payable to reduce the near-term costs to the patient. The insurer may decline to pay the provider and choose to pay the subscriber instead.

                      Control0..1
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Requirements

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

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

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

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

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                      ShortExtensions that cannot be ignored even if unrecognized
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

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

                      ShortCategory of recipient
                      Control1..1
                      BindingFor example codes, see ClaimPayeeTypeCodes
                      (example to http://hl7.org/fhir/ValueSet/payeetype|5.0.0)

                      A code for the party to be reimbursed.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Requirements

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

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

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

                      ShortRecipient reference
                      Comments

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

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

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

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

                      The referral information received by the claim author, it is not to be used when the author generates a referral for a patient. A copy of that referral may be provided as supporting information. Some insurers require proof of referral to pay for services or to pay specialist rates for services.

                      ShortTreatment referral
                      Comments

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

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

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

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

                      Healthcare encounters related to this claim.

                      ShortEncounters associated with the listed treatments
                      Comments

                      This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

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

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

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

                        Healthcare encounters related to this claim.

                        ShortGenerelle Informationen zu Aufnahme und Entlassung des Patienten
                        Comments

                        This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

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

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

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

                        Healthcare encounters related to this claim.

                        ShortInformationen zu Verlegungen innerhalb oder zwischen Krankenanstalten
                        Comments

                        This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

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

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

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

                        Facility where the services were provided.

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

                        Insurance adjudication can be dependant on where services were delivered.

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

                        A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.

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

                        For example DRG (Diagnosis Related Group) or a bundled billing code. A patient may have a diagnosis of a Myocardial Infarction and a DRG for HeartAttack would be assigned. The Claim item (and possible subsequent claims) would refer to the DRG for those line items that were for services related to the heart attack event.

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

                        Required to relate the current diagnosis to a package billing code that is then referenced on the individual claim items which are specific to the health condition covered by the package code.

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

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

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

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

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

                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                        ShortAdditional content defined by implementations
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                        ShortExtensions that cannot be ignored even if unrecognized
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

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

                        ShortSpecific event
                        Control1..1
                        BindingFor example codes, see DatesTypeCodes
                        (example to http://hl7.org/fhir/ValueSet/datestype|5.0.0)
                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        104. Claim.event.when[x]
                        Definition

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

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

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

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

                        Common to identify the responsible and supporting practitioners.

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

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

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

                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                        ShortAdditional content defined by implementations
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                        ShortExtensions that cannot be ignored even if unrecognized
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

                        A number to uniquely identify care team entries.

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

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

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

                        Member of the team who provided the product or service.

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

                        Often a regulatory requirement to specify the responsible provider.

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

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

                        ShortIndicator of the lead practitioner
                        Comments

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

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

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

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

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

                        ShortFunction within the team
                        Comments

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

                        Control0..1
                        BindingFor example codes, see ClaimCareTeamRoleCodes
                        (example to http://hl7.org/fhir/ValueSet/claim-careteamrole|5.0.0)

                        The role codes for the care team members.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Requirements

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

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

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

                        ShortPractitioner or provider specialization
                        Control0..1
                        BindingFor example codes, see ExampleProviderQualificationCodes
                        (example to http://hl7.org/fhir/ValueSet/provider-qualification|5.0.0)
                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Requirements

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

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

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

                        ShortSupporting information
                        Comments

                        Often there are multiple jurisdiction specific valuesets which are required.

                        Control2..*
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supportfalse
                        Summaryfalse
                        Requirements

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

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

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

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

                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

                          A number to uniquely identify supporting information entries.

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

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

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

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

                          ShortClassification of the supplied information
                          Comments

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

                          Control1..1
                          BindingFor example codes, see ClaimInformationCategoryCodes
                          (example to http://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0)

                          The valuset used for additional information category codes.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

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

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

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

                          ShortType of information
                          Control0..1
                          BindingFor example codes, see ExceptionCodes
                          (example to http://hl7.org/fhir/ValueSet/claim-exception|5.0.0)

                          The valuset used for additional information codes.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          Required to identify the kind of additional information.

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

                          The date when or period to which this information refers.

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

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

                          ShortData to be provided
                          Comments

                          Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.

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

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

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

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

                          ShortExplanation for the information
                          Comments

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

                          Control0..1
                          BindingFor example codes, see MissingToothReasonCodes
                          (example to http://hl7.org/fhir/ValueSet/missing-tooth-reason|5.0.0)

                          Reason codes for the missing teeth.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

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

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

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

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

                          Often there are multiple jurisdiction specific valuesets which are required.

                          Control1..1
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

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

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

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

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

                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

                          A number to uniquely identify supporting information entries.

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

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

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

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

                          ShortClassification of the supplied information
                          Comments

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

                          Control1..1
                          BindingFor example codes, see ClaimInformationCategoryCodes
                          (example to http://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0)

                          The valuset used for additional information category codes.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

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

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

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

                          ShortType of information
                          Control0..1
                          BindingFor example codes, see ExceptionCodes
                          (example to http://hl7.org/fhir/ValueSet/claim-exception|5.0.0)

                          The valuset used for additional information codes.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          Required to identify the kind of additional information.

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

                          The date when or period to which this information refers.

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

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

                          ShortData to be provided
                          Comments

                          Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.

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

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

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

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

                          ShortExplanation for the information
                          Comments

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

                          Control0..1
                          BindingFor example codes, see MissingToothReasonCodes
                          (example to http://hl7.org/fhir/ValueSet/missing-tooth-reason|5.0.0)

                          Reason codes for the missing teeth.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

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

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

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

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

                          Often there are multiple jurisdiction specific valuesets which are required.

                          Control1..1
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

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

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

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

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

                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

                          A number to uniquely identify supporting information entries.

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

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

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

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

                          ShortClassification of the supplied information
                          Comments

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

                          Control1..1
                          BindingFor example codes, see ClaimInformationCategoryCodes
                          (example to http://hl7.org/fhir/ValueSet/claim-informationcategory|5.0.0)

                          The valuset used for additional information category codes.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

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

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

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

                          ShortType of information
                          Control0..1
                          BindingFor example codes, see ExceptionCodes
                          (example to http://hl7.org/fhir/ValueSet/claim-exception|5.0.0)

                          The valuset used for additional information codes.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

                          Required to identify the kind of additional information.

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

                          The date when or period to which this information refers.

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

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

                          ShortData to be provided
                          Comments

                          Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.

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

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

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

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

                          ShortExplanation for the information
                          Comments

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

                          Control0..1
                          BindingFor example codes, see MissingToothReasonCodes
                          (example to http://hl7.org/fhir/ValueSet/missing-tooth-reason|5.0.0)

                          Reason codes for the missing teeth.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

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

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

                          Information about diagnoses relevant to the claim items.

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

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

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

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

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

                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          ShortAdditional content defined by implementations
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

                          A number to uniquely identify diagnosis entries.

                          ShortDiagnosis instance identifier
                          Comments

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

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

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

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

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

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

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

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

                          When the condition was observed or the relative ranking.

                          ShortTiming or nature of the diagnosis
                          Comments

                          For example: admitting, primary, secondary, discharge.

                          Control0..*
                          BindingFor example codes, see ExampleDiagnosisTypeCodes
                          (example to http://hl7.org/fhir/ValueSet/ex-diagnosistype|5.0.0)

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

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

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

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

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

                          ShortPresent on admission
                          Control0..1
                          BindingFor example codes, see ExampleDiagnosisOnAdmissionCodes
                          (example to http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission|5.0.0)

                          Present on admission.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supportfalse
                          Summaryfalse
                          Requirements

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

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

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

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

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

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

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

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

                          An Extension

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

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

                            ShortMedizinische Leistung - Abrechnungsrelevanz
                            Control0..1
                            TypeExtension(Medizinische Leistung - Abrechnungsrelevanz) (Extension Type: Coding)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            208. Claim.procedure.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

                            A number to uniquely identify procedure entries.

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

                            Necessary to provide a mechanism to link to claim details.

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

                            When the condition was observed or the relative ranking.

                            ShortCategory of Procedure
                            Comments

                            For example: primary, secondary.

                            Control0..*
                            BindingFor example codes, see ExampleProcedureTypeCodes
                            (example to http://hl7.org/fhir/ValueSet/ex-procedure-type|5.0.0)

                            Example procedure type codes.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Requirements

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

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

                            Date and optionally time the procedure was performed.

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

                            Required for auditing purposes.

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

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

                            ShortSpecific clinical procedure
                            Control1..1
                            TypeReference(MOPED Procedure)
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Requirements

                            This identifies the actual clinical procedure.

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

                            Unique Device Identifiers associated with this line item.

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

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

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

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

                            ShortPatient insurance information
                            Comments

                            All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'Coverage.subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.

                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Must Supportfalse
                            Summarytrue
                            Requirements

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

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

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

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

                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

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

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

                            To maintain order of the coverages.

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

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

                            ShortCoverage to be used for adjudication
                            Comments

                            A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies.

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

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

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

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

                            ShortPre-assigned Claim number
                            Comments

                            Only required in jurisdictions where insurers, rather than the provider, are required to send claims to insurers that appear after them in the list. This element is not required when 'subrogation=true'.

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

                            This will be the claim number should it be necessary to create this claim in the future. This is provided so that payors may forward claims to other payors in the Coordination of Benefit for adjudication rather than the provider being required to initiate each adjudication.

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

                            Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.

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

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

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

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

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

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

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

                            Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.

                            ShortPrior authorization reference number
                            Comments

                            This value is an alphanumeric string that may be provided over the phone, via text, via paper, or within a ClaimResponse resource and is not a FHIR Identifier.

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

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

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

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

                            ShortAdjudication results
                            Comments

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

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

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

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

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

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

                            When healthcare products and services are accident related, benefits may be payable under accident provisions of policies, such as automotive, etc before they are payable under normal health insurance.

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

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

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

                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            ShortAdditional content defined by implementations
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

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

                            ShortWhen the incident occurred
                            Comments

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

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

                            Required for audit purposes and adjudication.

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

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

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

                            Type of accident: work place, auto, etc.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supportfalse
                            Summaryfalse
                            Requirements

                            Coverage may be dependant on the type of accident.

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

                            The physical location of the accident event.

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

                            Required for audit purposes and determination of applicable insurance liability.

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

                            The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

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

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

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

                            A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

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

                            The items to be processed for adjudication.

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

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

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

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

                              A number to uniquely identify item entries.

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

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

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

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

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

                              Allows partners to uniquely identify components for tracking.

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

                              CareTeam members related to this service or product.

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

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

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

                              Diagnosis applicable for this service or product.

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

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

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

                              Procedures applicable for this service or product.

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

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

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

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

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

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

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

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

                              ShortRevenue or cost center code
                              Control0..1
                              BindingFor example codes, see ExampleRevenueCenterCodes
                              (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

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

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Needed in the processing of institutional claims.

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

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

                              ShortBenefit classification
                              Comments

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

                              Control0..1
                              BindingFor example codes, see BenefitCategoryCodes
                              (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

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

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

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

                              When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                              ShortBilling, service, product, or drug code
                              Comments

                              If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                              Control0..1
                              BindingFor example codes, see USCLSCodes
                              (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                              Allowable service and product codes.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Necessary to state what was provided or done.

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

                              This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                              ShortEnd of a range of codes
                              Control0..1
                              BindingFor example codes, see USCLSCodes
                              (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              286. Claim.item.request
                              Definition

                              Request or Referral for Goods or Service to be rendered.

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

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

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

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

                              ShortProduct or service billing modifiers
                              Comments

                              For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.

                              Control0..*
                              BindingFor example codes, see ModifierTypeCodes
                              (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

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

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

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

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

                              Identifies the program under which this may be recovered.

                              ShortProgram the product or service is provided under
                              Comments

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

                              Control0..*
                              BindingFor example codes, see ExampleProgramReasonCodes
                              (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                              Program specific reason codes.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

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

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

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

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

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

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

                              Where the product or service was provided.

                              ShortPlace of service or where product was supplied
                              Control0..1
                              BindingFor example codes, see ExampleServicePlaceCodes
                              (example to http://hl7.org/fhir/ValueSet/service-place|5.0.0)

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

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

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

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

                              The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

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

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

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

                              The number of repetitions of a service or product.

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

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

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

                              If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

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

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

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

                              A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                              ShortPrice scaling factor
                              Comments

                              To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

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

                              When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

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

                              The total of taxes applicable for this product or service.

                              ShortTotal tax
                              Control0..1
                              TypeMoney
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Required when taxes are not embedded in the unit price or provided as a separate service.

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

                              The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                              ShortTotal item cost
                              Comments

                              For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                              Control0..1
                              TypeMoney
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Provides the total amount claimed for the group (if a grouper) or the line item.

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

                              Unique Device Identifiers associated with this line item.

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

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

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

                              Physical location where the service is performed or applies.

                              ShortAnatomical location
                              Control0..*
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              312. Claim.item.bodySite.id
                              Definition

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

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

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

                              Physical service site on the patient (limb, tooth, etc.).

                              ShortLocation
                              Comments

                              For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                              Control1..*
                              BindingFor example codes, see OralSiteCodes
                              (example to http://hl7.org/fhir/ValueSet/tooth|5.0.0)
                              TypeCodeableReference(BodyStructure)
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Allows insurer to validate specific procedures.

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

                              A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                              ShortSub-location
                              Control0..*
                              BindingFor example codes, see SurfaceCodes
                              (example to http://hl7.org/fhir/ValueSet/surface|5.0.0)
                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Allows insurer to validate specific procedures.

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

                              Healthcare encounters related to this claim.

                              ShortEncounters associated with the listed treatments
                              Comments

                              This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                              Control0..*
                              TypeReference(Encounter)
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

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

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

                              A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

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

                              The items to be processed for adjudication.

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

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

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

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

                              A number to uniquely identify item entries.

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

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

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

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

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

                              Allows partners to uniquely identify components for tracking.

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

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

                              ShortRevenue or cost center code
                              Control0..1
                              BindingFor example codes, see ExampleRevenueCenterCodes
                              (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

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

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Needed in the processing of institutional claims.

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

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

                              ShortBenefit classification
                              Comments

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

                              Control0..1
                              BindingFor example codes, see BenefitCategoryCodes
                              (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

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

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

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

                              When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                              ShortBilling, service, product, or drug code
                              Comments

                              If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                              Control0..1
                              BindingFor example codes, see USCLSCodes
                              (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                              Allowable service and product codes.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Necessary to state what was provided or done.

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

                              This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                              ShortEnd of a range of codes
                              Control0..1
                              BindingFor example codes, see USCLSCodes
                              (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              344. Claim.item.detail.modifier
                              Definition

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

                              ShortService/Product billing modifiers
                              Comments

                              For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                              Control0..*
                              BindingFor example codes, see ModifierTypeCodes
                              (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

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

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

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

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

                              Identifies the program under which this may be recovered.

                              ShortProgram the product or service is provided under
                              Comments

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

                              Control0..*
                              BindingFor example codes, see ExampleProgramReasonCodes
                              (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                              Program specific reason codes.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

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

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

                              The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

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

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

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

                              The number of repetitions of a service or product.

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

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

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

                              If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

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

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

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

                              A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                              ShortPrice scaling factor
                              Comments

                              To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

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

                              When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

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

                              The total of taxes applicable for this product or service.

                              ShortTotal tax
                              Control0..1
                              TypeMoney
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Required when taxes are not embedded in the unit price or provided as a separate service.

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

                              The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                              ShortTotal item cost
                              Comments

                              For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                              Control0..1
                              TypeMoney
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Provides the total amount claimed for the group (if a grouper) or the line item.

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

                              Unique Device Identifiers associated with this line item.

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

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

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

                              A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

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

                              The items to be processed for adjudication.

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

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

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

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

                              A number to uniquely identify item entries.

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

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

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

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

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

                              Allows partners to uniquely identify components for tracking.

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

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

                              ShortRevenue or cost center code
                              Control0..1
                              BindingFor example codes, see ExampleRevenueCenterCodes
                              (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

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

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Needed in the processing of institutional claims.

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

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

                              ShortBenefit classification
                              Comments

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

                              Control0..1
                              BindingFor example codes, see BenefitCategoryCodes
                              (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

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

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

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

                              When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                              ShortBilling, service, product, or drug code
                              Comments

                              If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                              Control0..1
                              BindingFor example codes, see USCLSCodes
                              (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                              Allowable service and product codes.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Necessary to state what was provided or done.

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

                              This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                              ShortEnd of a range of codes
                              Control0..1
                              BindingFor example codes, see USCLSCodes
                              (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              382. Claim.item.detail.subDetail.modifier
                              Definition

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

                              ShortService/Product billing modifiers
                              Comments

                              For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                              Control0..*
                              BindingFor example codes, see ModifierTypeCodes
                              (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

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

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

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

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

                              Identifies the program under which this may be recovered.

                              ShortProgram the product or service is provided under
                              Comments

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

                              Control0..*
                              BindingFor example codes, see ExampleProgramReasonCodes
                              (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                              Program specific reason codes.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

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

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

                              The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

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

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

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

                              The number of repetitions of a service or product.

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

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

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

                              If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

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

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

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

                              A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                              ShortPrice scaling factor
                              Comments

                              To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

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

                              When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

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

                              The total of taxes applicable for this product or service.

                              ShortTotal tax
                              Control0..1
                              TypeMoney
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Required when taxes are not embedded in the unit price or provided as a separate service.

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

                              The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                              ShortTotal item cost
                              Comments

                              For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                              Control0..1
                              TypeMoney
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Provides the total amount claimed for the group (if a grouper) or the line item.

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

                              Unique Device Identifiers associated with this line item.

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

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

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

                              A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

                              ShortProduct or service provided
                              Control1..1
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              The items to be processed for adjudication.

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

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

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

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

                              A number to uniquely identify item entries.

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

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

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

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

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

                              Allows partners to uniquely identify components for tracking.

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

                              CareTeam members related to this service or product.

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

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

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

                              Diagnosis applicable for this service or product.

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

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

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

                              Procedures applicable for this service or product.

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

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

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

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

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

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

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

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

                              ShortRevenue or cost center code
                              Control0..1
                              BindingFor example codes, see ExampleRevenueCenterCodes
                              (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

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

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Needed in the processing of institutional claims.

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

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

                              ShortBenefit classification
                              Comments

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

                              Control0..1
                              BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                              (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supportfalse
                              Summaryfalse
                              Requirements

                              Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

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

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

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

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              ShortAdditional content defined by implementations
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

                                A reference to a code defined by a terminology system.

                                ShortCode defined by a terminology system
                                Comments

                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                Control1..*
                                TypeCoding
                                Is Modifierfalse
                                Summarytrue
                                Requirements

                                Allows for alternative encodings within a code system, and translations to other code systems.

                                Pattern Value{
                                  "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                  "code" : "LDFPLK"
                                }
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                430. Claim.item:Leistungskomponente.category.text
                                Definition

                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                ShortPlain text representation of the concept
                                Comments

                                Very often the text is the same as a displayName of one of the codings.

                                Control0..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Requirements

                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                432. Claim.item:Leistungskomponente.productOrService
                                Definition

                                When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                ShortBilling, service, product, or drug code
                                Comments

                                If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                Control0..1
                                BindingFor example codes, see USCLSCodes
                                (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                Allowable service and product codes.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                Necessary to state what was provided or done.

                                Alternate NamesDrug Code, Bill Code, Service Code
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                434. Claim.item:Leistungskomponente.productOrServiceEnd
                                Definition

                                This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                ShortEnd of a range of codes
                                Control0..1
                                BindingFor example codes, see USCLSCodes
                                (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                436. Claim.item:Leistungskomponente.request
                                Definition

                                Request or Referral for Goods or Service to be rendered.

                                ShortRequest or Referral for Service
                                Control0..*
                                TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                May identify the service to be provided or provider authorization for the service.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                438. Claim.item:Leistungskomponente.modifier
                                Definition

                                Item typification or modifiers codes to convey additional context for the product or service.

                                ShortProduct or service billing modifiers
                                Comments

                                For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.

                                Control0..*
                                BindingFor example codes, see ModifierTypeCodes
                                (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                To support inclusion of the item for adjudication or to charge an elevated fee.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                440. Claim.item:Leistungskomponente.programCode
                                Definition

                                Identifies the program under which this may be recovered.

                                ShortProgram the product or service is provided under
                                Comments

                                For example: Neonatal program, child dental program or drug users recovery program.

                                Control0..*
                                BindingFor example codes, see ExampleProgramReasonCodes
                                (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                Program specific reason codes.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                442. Claim.item:Leistungskomponente.serviced[x]
                                Definition

                                The date or dates when the service or product was supplied, performed or completed.

                                ShortDate or dates of service or product delivery
                                Control0..1
                                TypeChoice of: date, Period
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                444. Claim.item:Leistungskomponente.location[x]
                                Definition

                                Where the product or service was provided.

                                ShortPlace of service or where product was supplied
                                Control0..1
                                BindingFor example codes, see ExampleServicePlaceCodes
                                (example to http://hl7.org/fhir/ValueSet/service-place|5.0.0)

                                Place of service: pharmacy, school, prison, etc.

                                TypeChoice of: CodeableConcept, Address, Reference(Location)
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                446. Claim.item:Leistungskomponente.patientPaid
                                Definition

                                The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                ShortPaid by the patient
                                Control0..1
                                TypeMoney
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                448. Claim.item:Leistungskomponente.quantity
                                Definition

                                The number of repetitions of a service or product.

                                ShortPunkteanzahl
                                Control1..1
                                TypeQuantity(SimpleQuantity)
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Requirements

                                Required when the product or service code does not convey the quantity provided.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                450. Claim.item:Leistungskomponente.quantity.id
                                Definition

                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                ShortUnique id for inter-element referencing
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                Typeid
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                452. Claim.item:Leistungskomponente.quantity.extension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                ShortAdditional content defined by implementations
                                Comments

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Alternate Namesextensions, user content
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 454. Claim.item:Leistungskomponente.quantity.value
                                  Definition

                                  The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                  ShortNumerical value (with implicit precision)
                                  Comments

                                  The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                  Control0..1
                                  Typedecimal
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  Precision is handled implicitly in almost all cases of measurement.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  456. Claim.item:Leistungskomponente.quantity.comparator
                                  Definition

                                  Not allowed to be used in this context

                                  Short< | <= | >= | > | ad - how to understand the value
                                  Control0..0
                                  BindingThe codes SHALL be taken from QuantityComparator
                                  (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                  How the Quantity should be understood and represented.

                                  Typecode
                                  Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                  Meaning if MissingIf there is no comparator, then there is no modification of the value
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  458. Claim.item:Leistungskomponente.quantity.unit
                                  Definition

                                  A human-readable form of the unit.

                                  ShortUnit representation
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                  Pattern ValueLKF Punkte
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  460. Claim.item:Leistungskomponente.quantity.system
                                  Definition

                                  The identification of the system that provides the coded form of the unit.

                                  ShortSystem that defines coded unit form
                                  Control0..1
                                  This element is affected by the following invariants: qty-3
                                  Typeuri
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  Need to know the system that defines the coded form of the unit.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  462. Claim.item:Leistungskomponente.quantity.code
                                  Definition

                                  A computer processable form of the unit in some unit representation system.

                                  ShortCoded form of the unit
                                  Comments

                                  The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                  Control0..1
                                  This element is affected by the following invariants: qty-3
                                  Typecode
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  464. Claim.item:Leistungskomponente.unitPrice
                                  Definition

                                  If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                  ShortFee, charge or cost per item
                                  Control0..1
                                  TypeMoney
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  The amount charged to the patient by the provider for a single unit.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  466. Claim.item:Leistungskomponente.factor
                                  Definition

                                  A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                  ShortPrice scaling factor
                                  Comments

                                  To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                  Control0..1
                                  Typedecimal
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  468. Claim.item:Leistungskomponente.tax
                                  Definition

                                  The total of taxes applicable for this product or service.

                                  ShortTotal tax
                                  Control0..1
                                  TypeMoney
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Required when taxes are not embedded in the unit price or provided as a separate service.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  470. Claim.item:Leistungskomponente.net
                                  Definition

                                  The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                  ShortTotal item cost
                                  Comments

                                  For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                  Control0..1
                                  TypeMoney
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Provides the total amount claimed for the group (if a grouper) or the line item.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  472. Claim.item:Leistungskomponente.udi
                                  Definition

                                  Unique Device Identifiers associated with this line item.

                                  ShortUnique device identifier
                                  Control0..*
                                  TypeReference(Device)
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  The UDI code allows the insurer to obtain device level information on the product supplied.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  474. Claim.item:Leistungskomponente.bodySite
                                  Definition

                                  Physical location where the service is performed or applies.

                                  ShortAnatomical location
                                  Control0..*
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  476. Claim.item:Leistungskomponente.bodySite.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  478. Claim.item:Leistungskomponente.bodySite.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  480. Claim.item:Leistungskomponente.bodySite.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                  Summarytrue
                                  Requirements

                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                  Alternate Namesextensions, user content, modifiers
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  482. Claim.item:Leistungskomponente.bodySite.site
                                  Definition

                                  Physical service site on the patient (limb, tooth, etc.).

                                  ShortLocation
                                  Comments

                                  For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                  Control1..*
                                  BindingFor example codes, see OralSiteCodes
                                  (example to http://hl7.org/fhir/ValueSet/tooth|5.0.0)
                                  TypeCodeableReference(BodyStructure)
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Allows insurer to validate specific procedures.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  484. Claim.item:Leistungskomponente.bodySite.subSite
                                  Definition

                                  A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                  ShortSub-location
                                  Control0..*
                                  BindingFor example codes, see SurfaceCodes
                                  (example to http://hl7.org/fhir/ValueSet/surface|5.0.0)
                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Allows insurer to validate specific procedures.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  486. Claim.item:Leistungskomponente.encounter
                                  Definition

                                  Healthcare encounters related to this claim.

                                  ShortEncounters associated with the listed treatments
                                  Comments

                                  This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                                  Control0..*
                                  TypeReference(Encounter)
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Used in some jurisdictions to link clinical events to claim items.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  488. Claim.item:Leistungskomponente.detail
                                  Definition

                                  A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                  ShortProduct or service provided
                                  Control0..*
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  The items to be processed for adjudication.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  490. Claim.item:Leistungskomponente.detail.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  492. Claim.item:Leistungskomponente.detail.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  494. Claim.item:Leistungskomponente.detail.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                  Summarytrue
                                  Requirements

                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                  Alternate Namesextensions, user content, modifiers
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  496. Claim.item:Leistungskomponente.detail.sequence
                                  Definition

                                  A number to uniquely identify item entries.

                                  ShortItem instance identifier
                                  Control1..1
                                  TypepositiveInt
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  498. Claim.item:Leistungskomponente.detail.traceNumber
                                  Definition

                                  Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                  ShortNumber for tracking
                                  Control0..*
                                  TypeIdentifier
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Allows partners to uniquely identify components for tracking.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  500. Claim.item:Leistungskomponente.detail.revenue
                                  Definition

                                  The type of revenue or cost center providing the product and/or service.

                                  ShortRevenue or cost center code
                                  Control0..1
                                  BindingFor example codes, see ExampleRevenueCenterCodes
                                  (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                  Codes for the revenue or cost centers supplying the service and/or products.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Needed in the processing of institutional claims.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  502. Claim.item:Leistungskomponente.detail.category
                                  Definition

                                  Code to identify the general type of benefits under which products and services are provided.

                                  ShortBenefit classification
                                  Comments

                                  Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                  Control0..1
                                  BindingFor example codes, see BenefitCategoryCodes
                                  (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                  Benefit categories such as: oral-basic, major, glasses.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  504. Claim.item:Leistungskomponente.detail.productOrService
                                  Definition

                                  When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                  ShortBilling, service, product, or drug code
                                  Comments

                                  If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                  Control0..1
                                  BindingFor example codes, see USCLSCodes
                                  (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                  Allowable service and product codes.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Necessary to state what was provided or done.

                                  Alternate NamesDrug Code, Bill Code, Service Code
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  506. Claim.item:Leistungskomponente.detail.productOrServiceEnd
                                  Definition

                                  This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                  ShortEnd of a range of codes
                                  Control0..1
                                  BindingFor example codes, see USCLSCodes
                                  (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  508. Claim.item:Leistungskomponente.detail.modifier
                                  Definition

                                  Item typification or modifiers codes to convey additional context for the product or service.

                                  ShortService/Product billing modifiers
                                  Comments

                                  For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                  Control0..*
                                  BindingFor example codes, see ModifierTypeCodes
                                  (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                  Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  To support inclusion of the item for adjudication or to charge an elevated fee.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  510. Claim.item:Leistungskomponente.detail.programCode
                                  Definition

                                  Identifies the program under which this may be recovered.

                                  ShortProgram the product or service is provided under
                                  Comments

                                  For example: Neonatal program, child dental program or drug users recovery program.

                                  Control0..*
                                  BindingFor example codes, see ExampleProgramReasonCodes
                                  (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                  Program specific reason codes.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  512. Claim.item:Leistungskomponente.detail.patientPaid
                                  Definition

                                  The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                  ShortPaid by the patient
                                  Control0..1
                                  TypeMoney
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  514. Claim.item:Leistungskomponente.detail.quantity
                                  Definition

                                  The number of repetitions of a service or product.

                                  ShortCount of products or services
                                  Control0..1
                                  TypeQuantity(SimpleQuantity)
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Required when the product or service code does not convey the quantity provided.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  516. Claim.item:Leistungskomponente.detail.unitPrice
                                  Definition

                                  If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                  ShortFee, charge or cost per item
                                  Control0..1
                                  TypeMoney
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  The amount charged to the patient by the provider for a single unit.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  518. Claim.item:Leistungskomponente.detail.factor
                                  Definition

                                  A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                  ShortPrice scaling factor
                                  Comments

                                  To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                  Control0..1
                                  Typedecimal
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  520. Claim.item:Leistungskomponente.detail.tax
                                  Definition

                                  The total of taxes applicable for this product or service.

                                  ShortTotal tax
                                  Control0..1
                                  TypeMoney
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Required when taxes are not embedded in the unit price or provided as a separate service.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  522. Claim.item:Leistungskomponente.detail.net
                                  Definition

                                  The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                  ShortTotal item cost
                                  Comments

                                  For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                  Control0..1
                                  TypeMoney
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Provides the total amount claimed for the group (if a grouper) or the line item.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  524. Claim.item:Leistungskomponente.detail.udi
                                  Definition

                                  Unique Device Identifiers associated with this line item.

                                  ShortUnique device identifier
                                  Control0..*
                                  TypeReference(Device)
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  The UDI code allows the insurer to obtain device level information on the product supplied.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  526. Claim.item:Leistungskomponente.detail.subDetail
                                  Definition

                                  A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                  ShortProduct or service provided
                                  Control0..*
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  The items to be processed for adjudication.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  528. Claim.item:Leistungskomponente.detail.subDetail.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  530. Claim.item:Leistungskomponente.detail.subDetail.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  532. Claim.item:Leistungskomponente.detail.subDetail.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                  Summarytrue
                                  Requirements

                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                  Alternate Namesextensions, user content, modifiers
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  534. Claim.item:Leistungskomponente.detail.subDetail.sequence
                                  Definition

                                  A number to uniquely identify item entries.

                                  ShortItem instance identifier
                                  Control1..1
                                  TypepositiveInt
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  536. Claim.item:Leistungskomponente.detail.subDetail.traceNumber
                                  Definition

                                  Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                  ShortNumber for tracking
                                  Control0..*
                                  TypeIdentifier
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Allows partners to uniquely identify components for tracking.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  538. Claim.item:Leistungskomponente.detail.subDetail.revenue
                                  Definition

                                  The type of revenue or cost center providing the product and/or service.

                                  ShortRevenue or cost center code
                                  Control0..1
                                  BindingFor example codes, see ExampleRevenueCenterCodes
                                  (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                  Codes for the revenue or cost centers supplying the service and/or products.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Needed in the processing of institutional claims.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  540. Claim.item:Leistungskomponente.detail.subDetail.category
                                  Definition

                                  Code to identify the general type of benefits under which products and services are provided.

                                  ShortBenefit classification
                                  Comments

                                  Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                  Control0..1
                                  BindingFor example codes, see BenefitCategoryCodes
                                  (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                  Benefit categories such as: oral-basic, major, glasses.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  542. Claim.item:Leistungskomponente.detail.subDetail.productOrService
                                  Definition

                                  When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                  ShortBilling, service, product, or drug code
                                  Comments

                                  If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                  Control0..1
                                  BindingFor example codes, see USCLSCodes
                                  (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                  Allowable service and product codes.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Necessary to state what was provided or done.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  544. Claim.item:Leistungskomponente.detail.subDetail.productOrServiceEnd
                                  Definition

                                  This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                  ShortEnd of a range of codes
                                  Control0..1
                                  BindingFor example codes, see USCLSCodes
                                  (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  546. Claim.item:Leistungskomponente.detail.subDetail.modifier
                                  Definition

                                  Item typification or modifiers codes to convey additional context for the product or service.

                                  ShortService/Product billing modifiers
                                  Comments

                                  For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                  Control0..*
                                  BindingFor example codes, see ModifierTypeCodes
                                  (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                  Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  To support inclusion of the item for adjudication or to charge an elevated fee.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  548. Claim.item:Leistungskomponente.detail.subDetail.programCode
                                  Definition

                                  Identifies the program under which this may be recovered.

                                  ShortProgram the product or service is provided under
                                  Comments

                                  For example: Neonatal program, child dental program or drug users recovery program.

                                  Control0..*
                                  BindingFor example codes, see ExampleProgramReasonCodes
                                  (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                  Program specific reason codes.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  550. Claim.item:Leistungskomponente.detail.subDetail.patientPaid
                                  Definition

                                  The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                  ShortPaid by the patient
                                  Control0..1
                                  TypeMoney
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  552. Claim.item:Leistungskomponente.detail.subDetail.quantity
                                  Definition

                                  The number of repetitions of a service or product.

                                  ShortCount of products or services
                                  Control0..1
                                  TypeQuantity(SimpleQuantity)
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Required when the product or service code does not convey the quantity provided.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  554. Claim.item:Leistungskomponente.detail.subDetail.unitPrice
                                  Definition

                                  If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                  ShortFee, charge or cost per item
                                  Control0..1
                                  TypeMoney
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  The amount charged to the patient by the provider for a single unit.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  556. Claim.item:Leistungskomponente.detail.subDetail.factor
                                  Definition

                                  A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                  ShortPrice scaling factor
                                  Comments

                                  To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                  Control0..1
                                  Typedecimal
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  558. Claim.item:Leistungskomponente.detail.subDetail.tax
                                  Definition

                                  The total of taxes applicable for this product or service.

                                  ShortTotal tax
                                  Control0..1
                                  TypeMoney
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Required when taxes are not embedded in the unit price or provided as a separate service.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  560. Claim.item:Leistungskomponente.detail.subDetail.net
                                  Definition

                                  The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                  ShortTotal item cost
                                  Comments

                                  For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                  Control0..1
                                  TypeMoney
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Provides the total amount claimed for the group (if a grouper) or the line item.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  562. Claim.item:Leistungskomponente.detail.subDetail.udi
                                  Definition

                                  Unique Device Identifiers associated with this line item.

                                  ShortUnique device identifier
                                  Control0..*
                                  TypeReference(Device)
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  The UDI code allows the insurer to obtain device level information on the product supplied.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  564. Claim.item:Tageskomponente
                                  Slice NameTageskomponente
                                  Definition

                                  A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

                                  ShortProduct or service provided
                                  Control1..1
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  The items to be processed for adjudication.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  566. Claim.item:Tageskomponente.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  568. Claim.item:Tageskomponente.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  570. Claim.item:Tageskomponente.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                  Summarytrue
                                  Requirements

                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                  Alternate Namesextensions, user content, modifiers
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  572. Claim.item:Tageskomponente.sequence
                                  Definition

                                  A number to uniquely identify item entries.

                                  ShortItem instance identifier
                                  Control1..1
                                  TypepositiveInt
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  574. Claim.item:Tageskomponente.traceNumber
                                  Definition

                                  Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                  ShortNumber for tracking
                                  Control0..*
                                  TypeIdentifier
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Allows partners to uniquely identify components for tracking.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  576. Claim.item:Tageskomponente.careTeamSequence
                                  Definition

                                  CareTeam members related to this service or product.

                                  ShortApplicable careTeam members
                                  Control0..*
                                  TypepositiveInt
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Need to identify the individuals and their roles in the provision of the product or service.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  578. Claim.item:Tageskomponente.diagnosisSequence
                                  Definition

                                  Diagnosis applicable for this service or product.

                                  ShortApplicable diagnoses
                                  Control0..*
                                  TypepositiveInt
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Need to related the product or service to the associated diagnoses.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  580. Claim.item:Tageskomponente.procedureSequence
                                  Definition

                                  Procedures applicable for this service or product.

                                  ShortApplicable procedures
                                  Control0..*
                                  TypepositiveInt
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Need to provide any listed specific procedures to support the product or service being claimed.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  582. Claim.item:Tageskomponente.informationSequence
                                  Definition

                                  Exceptions, special conditions and supporting information applicable for this service or product.

                                  ShortApplicable exception and supporting information
                                  Control0..*
                                  TypepositiveInt
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Need to reference the supporting information items that relate directly to this product or service.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  584. Claim.item:Tageskomponente.revenue
                                  Definition

                                  The type of revenue or cost center providing the product and/or service.

                                  ShortRevenue or cost center code
                                  Control0..1
                                  BindingFor example codes, see ExampleRevenueCenterCodes
                                  (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                  Codes for the revenue or cost centers supplying the service and/or products.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Needed in the processing of institutional claims.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  586. Claim.item:Tageskomponente.category
                                  Definition

                                  Code to identify the general type of benefits under which products and services are provided.

                                  ShortBenefit classification
                                  Comments

                                  Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                  Control0..1
                                  BindingFor example codes, see BenefitCategoryCodes
                                  (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                  Benefit categories such as: oral-basic, major, glasses.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Requirements

                                  Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  588. Claim.item:Tageskomponente.category.id
                                  Definition

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  Typeid
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  590. Claim.item:Tageskomponente.category.extension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  ShortAdditional content defined by implementations
                                  Comments

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Control0..*
                                  TypeExtension
                                  Is Modifierfalse
                                  Summaryfalse
                                  Alternate Namesextensions, user content
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ url
                                  • 592. Claim.item:Tageskomponente.category.coding
                                    Definition

                                    A reference to a code defined by a terminology system.

                                    ShortCode defined by a terminology system
                                    Comments

                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                    Control1..*
                                    BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                    (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                    TypeCoding
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

                                    Allows for alternative encodings within a code system, and translations to other code systems.

                                    Pattern Value{
                                      "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                      "code" : "LDFPTK"
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    594. Claim.item:Tageskomponente.category.text
                                    Definition

                                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                    ShortPlain text representation of the concept
                                    Comments

                                    Very often the text is the same as a displayName of one of the codings.

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Summarytrue
                                    Requirements

                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    596. Claim.item:Tageskomponente.productOrService
                                    Definition

                                    When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                    ShortBilling, service, product, or drug code
                                    Comments

                                    If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                    Control0..1
                                    BindingFor example codes, see USCLSCodes
                                    (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                    Allowable service and product codes.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Requirements

                                    Necessary to state what was provided or done.

                                    Alternate NamesDrug Code, Bill Code, Service Code
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    598. Claim.item:Tageskomponente.productOrServiceEnd
                                    Definition

                                    This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                    ShortEnd of a range of codes
                                    Control0..1
                                    BindingFor example codes, see USCLSCodes
                                    (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    600. Claim.item:Tageskomponente.request
                                    Definition

                                    Request or Referral for Goods or Service to be rendered.

                                    ShortRequest or Referral for Service
                                    Control0..*
                                    TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Requirements

                                    May identify the service to be provided or provider authorization for the service.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    602. Claim.item:Tageskomponente.modifier
                                    Definition

                                    Item typification or modifiers codes to convey additional context for the product or service.

                                    ShortProduct or service billing modifiers
                                    Comments

                                    For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.

                                    Control0..*
                                    BindingFor example codes, see ModifierTypeCodes
                                    (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                    Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Requirements

                                    To support inclusion of the item for adjudication or to charge an elevated fee.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    604. Claim.item:Tageskomponente.programCode
                                    Definition

                                    Identifies the program under which this may be recovered.

                                    ShortProgram the product or service is provided under
                                    Comments

                                    For example: Neonatal program, child dental program or drug users recovery program.

                                    Control0..*
                                    BindingFor example codes, see ExampleProgramReasonCodes
                                    (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                    Program specific reason codes.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Requirements

                                    Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    606. Claim.item:Tageskomponente.serviced[x]
                                    Definition

                                    The date or dates when the service or product was supplied, performed or completed.

                                    ShortDate or dates of service or product delivery
                                    Control0..1
                                    TypeChoice of: date, Period
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supportfalse
                                    Summaryfalse
                                    Requirements

                                    Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    608. Claim.item:Tageskomponente.location[x]
                                    Definition

                                    Where the product or service was provided.

                                    ShortPlace of service or where product was supplied
                                    Control0..1
                                    BindingFor example codes, see ExampleServicePlaceCodes
                                    (example to http://hl7.org/fhir/ValueSet/service-place|5.0.0)

                                    Place of service: pharmacy, school, prison, etc.

                                    TypeChoice of: CodeableConcept, Address, Reference(Location)
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Requirements

                                    The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    610. Claim.item:Tageskomponente.patientPaid
                                    Definition

                                    The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                    ShortPaid by the patient
                                    Control0..1
                                    TypeMoney
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Requirements

                                    Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    612. Claim.item:Tageskomponente.quantity
                                    Definition

                                    The number of repetitions of a service or product.

                                    ShortPunkteanzahl
                                    Control1..1
                                    TypeQuantity(SimpleQuantity)
                                    Is Modifierfalse
                                    Must Supportfalse
                                    Summaryfalse
                                    Requirements

                                    Required when the product or service code does not convey the quantity provided.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    614. Claim.item:Tageskomponente.quantity.id
                                    Definition

                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    Typeid
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    616. Claim.item:Tageskomponente.quantity.extension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                    ShortAdditional content defined by implementations
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 618. Claim.item:Tageskomponente.quantity.value
                                      Definition

                                      The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                      ShortNumerical value (with implicit precision)
                                      Comments

                                      The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                      Control1..1
                                      Typedecimal
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Precision is handled implicitly in almost all cases of measurement.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      620. Claim.item:Tageskomponente.quantity.comparator
                                      Definition

                                      Not allowed to be used in this context

                                      Short< | <= | >= | > | ad - how to understand the value
                                      Control0..0
                                      BindingThe codes SHALL be taken from QuantityComparator
                                      (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                      How the Quantity should be understood and represented.

                                      Typecode
                                      Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                      Meaning if MissingIf there is no comparator, then there is no modification of the value
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      622. Claim.item:Tageskomponente.quantity.unit
                                      Definition

                                      A human-readable form of the unit.

                                      ShortUnit representation
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                      Pattern ValueLKF Punkte
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      624. Claim.item:Tageskomponente.quantity.system
                                      Definition

                                      The identification of the system that provides the coded form of the unit.

                                      ShortSystem that defines coded unit form
                                      Control0..1
                                      This element is affected by the following invariants: qty-3
                                      Typeuri
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Need to know the system that defines the coded form of the unit.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      626. Claim.item:Tageskomponente.quantity.code
                                      Definition

                                      A computer processable form of the unit in some unit representation system.

                                      ShortCoded form of the unit
                                      Comments

                                      The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                      Control0..1
                                      This element is affected by the following invariants: qty-3
                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      628. Claim.item:Tageskomponente.unitPrice
                                      Definition

                                      If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                      ShortFee, charge or cost per item
                                      Control0..1
                                      TypeMoney
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      The amount charged to the patient by the provider for a single unit.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      630. Claim.item:Tageskomponente.factor
                                      Definition

                                      A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                      ShortPrice scaling factor
                                      Comments

                                      To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                      Control0..1
                                      Typedecimal
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      632. Claim.item:Tageskomponente.tax
                                      Definition

                                      The total of taxes applicable for this product or service.

                                      ShortTotal tax
                                      Control0..1
                                      TypeMoney
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Required when taxes are not embedded in the unit price or provided as a separate service.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      634. Claim.item:Tageskomponente.net
                                      Definition

                                      The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                      ShortTotal item cost
                                      Comments

                                      For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                      Control0..1
                                      TypeMoney
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Provides the total amount claimed for the group (if a grouper) or the line item.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      636. Claim.item:Tageskomponente.udi
                                      Definition

                                      Unique Device Identifiers associated with this line item.

                                      ShortUnique device identifier
                                      Control0..*
                                      TypeReference(Device)
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      The UDI code allows the insurer to obtain device level information on the product supplied.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      638. Claim.item:Tageskomponente.bodySite
                                      Definition

                                      Physical location where the service is performed or applies.

                                      ShortAnatomical location
                                      Control0..*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      640. Claim.item:Tageskomponente.bodySite.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      642. Claim.item:Tageskomponente.bodySite.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      644. Claim.item:Tageskomponente.bodySite.modifierExtension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                      Alternate Namesextensions, user content, modifiers
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      646. Claim.item:Tageskomponente.bodySite.site
                                      Definition

                                      Physical service site on the patient (limb, tooth, etc.).

                                      ShortLocation
                                      Comments

                                      For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                      Control1..*
                                      BindingFor example codes, see OralSiteCodes
                                      (example to http://hl7.org/fhir/ValueSet/tooth|5.0.0)
                                      TypeCodeableReference(BodyStructure)
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Allows insurer to validate specific procedures.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      648. Claim.item:Tageskomponente.bodySite.subSite
                                      Definition

                                      A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                      ShortSub-location
                                      Control0..*
                                      BindingFor example codes, see SurfaceCodes
                                      (example to http://hl7.org/fhir/ValueSet/surface|5.0.0)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Allows insurer to validate specific procedures.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      650. Claim.item:Tageskomponente.encounter
                                      Definition

                                      Healthcare encounters related to this claim.

                                      ShortEncounters associated with the listed treatments
                                      Comments

                                      This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                                      Control0..*
                                      TypeReference(Encounter)
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Used in some jurisdictions to link clinical events to claim items.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      652. Claim.item:Tageskomponente.detail
                                      Definition

                                      A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                      ShortProduct or service provided
                                      Control0..*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      The items to be processed for adjudication.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      654. Claim.item:Tageskomponente.detail.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      656. Claim.item:Tageskomponente.detail.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      658. Claim.item:Tageskomponente.detail.modifierExtension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                      Alternate Namesextensions, user content, modifiers
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      660. Claim.item:Tageskomponente.detail.sequence
                                      Definition

                                      A number to uniquely identify item entries.

                                      ShortItem instance identifier
                                      Control1..1
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      662. Claim.item:Tageskomponente.detail.traceNumber
                                      Definition

                                      Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                      ShortNumber for tracking
                                      Control0..*
                                      TypeIdentifier
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Allows partners to uniquely identify components for tracking.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      664. Claim.item:Tageskomponente.detail.revenue
                                      Definition

                                      The type of revenue or cost center providing the product and/or service.

                                      ShortRevenue or cost center code
                                      Control0..1
                                      BindingFor example codes, see ExampleRevenueCenterCodes
                                      (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                      Codes for the revenue or cost centers supplying the service and/or products.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Needed in the processing of institutional claims.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      666. Claim.item:Tageskomponente.detail.category
                                      Definition

                                      Code to identify the general type of benefits under which products and services are provided.

                                      ShortBenefit classification
                                      Comments

                                      Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                      Control0..1
                                      BindingFor example codes, see BenefitCategoryCodes
                                      (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                      Benefit categories such as: oral-basic, major, glasses.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      668. Claim.item:Tageskomponente.detail.productOrService
                                      Definition

                                      When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                      ShortBilling, service, product, or drug code
                                      Comments

                                      If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                      Control0..1
                                      BindingFor example codes, see USCLSCodes
                                      (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                      Allowable service and product codes.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Necessary to state what was provided or done.

                                      Alternate NamesDrug Code, Bill Code, Service Code
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      670. Claim.item:Tageskomponente.detail.productOrServiceEnd
                                      Definition

                                      This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                      ShortEnd of a range of codes
                                      Control0..1
                                      BindingFor example codes, see USCLSCodes
                                      (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      672. Claim.item:Tageskomponente.detail.modifier
                                      Definition

                                      Item typification or modifiers codes to convey additional context for the product or service.

                                      ShortService/Product billing modifiers
                                      Comments

                                      For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                      Control0..*
                                      BindingFor example codes, see ModifierTypeCodes
                                      (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                      Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      To support inclusion of the item for adjudication or to charge an elevated fee.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      674. Claim.item:Tageskomponente.detail.programCode
                                      Definition

                                      Identifies the program under which this may be recovered.

                                      ShortProgram the product or service is provided under
                                      Comments

                                      For example: Neonatal program, child dental program or drug users recovery program.

                                      Control0..*
                                      BindingFor example codes, see ExampleProgramReasonCodes
                                      (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                      Program specific reason codes.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      676. Claim.item:Tageskomponente.detail.patientPaid
                                      Definition

                                      The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                      ShortPaid by the patient
                                      Control0..1
                                      TypeMoney
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      678. Claim.item:Tageskomponente.detail.quantity
                                      Definition

                                      The number of repetitions of a service or product.

                                      ShortCount of products or services
                                      Control0..1
                                      TypeQuantity(SimpleQuantity)
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Required when the product or service code does not convey the quantity provided.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      680. Claim.item:Tageskomponente.detail.unitPrice
                                      Definition

                                      If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                      ShortFee, charge or cost per item
                                      Control0..1
                                      TypeMoney
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      The amount charged to the patient by the provider for a single unit.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      682. Claim.item:Tageskomponente.detail.factor
                                      Definition

                                      A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                      ShortPrice scaling factor
                                      Comments

                                      To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                      Control0..1
                                      Typedecimal
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      684. Claim.item:Tageskomponente.detail.tax
                                      Definition

                                      The total of taxes applicable for this product or service.

                                      ShortTotal tax
                                      Control0..1
                                      TypeMoney
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Required when taxes are not embedded in the unit price or provided as a separate service.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      686. Claim.item:Tageskomponente.detail.net
                                      Definition

                                      The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                      ShortTotal item cost
                                      Comments

                                      For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                      Control0..1
                                      TypeMoney
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Provides the total amount claimed for the group (if a grouper) or the line item.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      688. Claim.item:Tageskomponente.detail.udi
                                      Definition

                                      Unique Device Identifiers associated with this line item.

                                      ShortUnique device identifier
                                      Control0..*
                                      TypeReference(Device)
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      The UDI code allows the insurer to obtain device level information on the product supplied.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      690. Claim.item:Tageskomponente.detail.subDetail
                                      Definition

                                      A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                      ShortProduct or service provided
                                      Control0..*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      The items to be processed for adjudication.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      692. Claim.item:Tageskomponente.detail.subDetail.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      694. Claim.item:Tageskomponente.detail.subDetail.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      696. Claim.item:Tageskomponente.detail.subDetail.modifierExtension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                      Alternate Namesextensions, user content, modifiers
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      698. Claim.item:Tageskomponente.detail.subDetail.sequence
                                      Definition

                                      A number to uniquely identify item entries.

                                      ShortItem instance identifier
                                      Control1..1
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      700. Claim.item:Tageskomponente.detail.subDetail.traceNumber
                                      Definition

                                      Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                      ShortNumber for tracking
                                      Control0..*
                                      TypeIdentifier
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Allows partners to uniquely identify components for tracking.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      702. Claim.item:Tageskomponente.detail.subDetail.revenue
                                      Definition

                                      The type of revenue or cost center providing the product and/or service.

                                      ShortRevenue or cost center code
                                      Control0..1
                                      BindingFor example codes, see ExampleRevenueCenterCodes
                                      (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                      Codes for the revenue or cost centers supplying the service and/or products.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Needed in the processing of institutional claims.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      704. Claim.item:Tageskomponente.detail.subDetail.category
                                      Definition

                                      Code to identify the general type of benefits under which products and services are provided.

                                      ShortBenefit classification
                                      Comments

                                      Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                      Control0..1
                                      BindingFor example codes, see BenefitCategoryCodes
                                      (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                      Benefit categories such as: oral-basic, major, glasses.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      706. Claim.item:Tageskomponente.detail.subDetail.productOrService
                                      Definition

                                      When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                      ShortBilling, service, product, or drug code
                                      Comments

                                      If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                      Control0..1
                                      BindingFor example codes, see USCLSCodes
                                      (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                      Allowable service and product codes.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Necessary to state what was provided or done.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      708. Claim.item:Tageskomponente.detail.subDetail.productOrServiceEnd
                                      Definition

                                      This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                      ShortEnd of a range of codes
                                      Control0..1
                                      BindingFor example codes, see USCLSCodes
                                      (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      710. Claim.item:Tageskomponente.detail.subDetail.modifier
                                      Definition

                                      Item typification or modifiers codes to convey additional context for the product or service.

                                      ShortService/Product billing modifiers
                                      Comments

                                      For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                      Control0..*
                                      BindingFor example codes, see ModifierTypeCodes
                                      (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                      Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      To support inclusion of the item for adjudication or to charge an elevated fee.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      712. Claim.item:Tageskomponente.detail.subDetail.programCode
                                      Definition

                                      Identifies the program under which this may be recovered.

                                      ShortProgram the product or service is provided under
                                      Comments

                                      For example: Neonatal program, child dental program or drug users recovery program.

                                      Control0..*
                                      BindingFor example codes, see ExampleProgramReasonCodes
                                      (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                      Program specific reason codes.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      714. Claim.item:Tageskomponente.detail.subDetail.patientPaid
                                      Definition

                                      The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                      ShortPaid by the patient
                                      Control0..1
                                      TypeMoney
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      716. Claim.item:Tageskomponente.detail.subDetail.quantity
                                      Definition

                                      The number of repetitions of a service or product.

                                      ShortCount of products or services
                                      Control0..1
                                      TypeQuantity(SimpleQuantity)
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Required when the product or service code does not convey the quantity provided.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      718. Claim.item:Tageskomponente.detail.subDetail.unitPrice
                                      Definition

                                      If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                      ShortFee, charge or cost per item
                                      Control0..1
                                      TypeMoney
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      The amount charged to the patient by the provider for a single unit.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      720. Claim.item:Tageskomponente.detail.subDetail.factor
                                      Definition

                                      A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                      ShortPrice scaling factor
                                      Comments

                                      To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                      Control0..1
                                      Typedecimal
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      722. Claim.item:Tageskomponente.detail.subDetail.tax
                                      Definition

                                      The total of taxes applicable for this product or service.

                                      ShortTotal tax
                                      Control0..1
                                      TypeMoney
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Required when taxes are not embedded in the unit price or provided as a separate service.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      724. Claim.item:Tageskomponente.detail.subDetail.net
                                      Definition

                                      The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                      ShortTotal item cost
                                      Comments

                                      For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                      Control0..1
                                      TypeMoney
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Provides the total amount claimed for the group (if a grouper) or the line item.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      726. Claim.item:Tageskomponente.detail.subDetail.udi
                                      Definition

                                      Unique Device Identifiers associated with this line item.

                                      ShortUnique device identifier
                                      Control0..*
                                      TypeReference(Device)
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      The UDI code allows the insurer to obtain device level information on the product supplied.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      728. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente
                                      Slice NamePunkteBelagsdauerausreisserUntenLeistungskomponente
                                      Definition

                                      A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

                                      ShortProduct or service provided
                                      Control0..1
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      The items to be processed for adjudication.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      730. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      732. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      734. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.modifierExtension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                      Summarytrue
                                      Requirements

                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                      Alternate Namesextensions, user content, modifiers
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      736. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.sequence
                                      Definition

                                      A number to uniquely identify item entries.

                                      ShortItem instance identifier
                                      Control1..1
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      738. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.traceNumber
                                      Definition

                                      Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                      ShortNumber for tracking
                                      Control0..*
                                      TypeIdentifier
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Allows partners to uniquely identify components for tracking.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      740. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.careTeamSequence
                                      Definition

                                      CareTeam members related to this service or product.

                                      ShortApplicable careTeam members
                                      Control0..*
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Need to identify the individuals and their roles in the provision of the product or service.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      742. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.diagnosisSequence
                                      Definition

                                      Diagnosis applicable for this service or product.

                                      ShortApplicable diagnoses
                                      Control0..*
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Need to related the product or service to the associated diagnoses.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      744. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.procedureSequence
                                      Definition

                                      Procedures applicable for this service or product.

                                      ShortApplicable procedures
                                      Control0..*
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Need to provide any listed specific procedures to support the product or service being claimed.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      746. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.informationSequence
                                      Definition

                                      Exceptions, special conditions and supporting information applicable for this service or product.

                                      ShortApplicable exception and supporting information
                                      Control0..*
                                      TypepositiveInt
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Need to reference the supporting information items that relate directly to this product or service.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      748. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.revenue
                                      Definition

                                      The type of revenue or cost center providing the product and/or service.

                                      ShortRevenue or cost center code
                                      Control0..1
                                      BindingFor example codes, see ExampleRevenueCenterCodes
                                      (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                      Codes for the revenue or cost centers supplying the service and/or products.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Needed in the processing of institutional claims.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      750. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.category
                                      Definition

                                      Code to identify the general type of benefits under which products and services are provided.

                                      ShortBenefit classification
                                      Comments

                                      Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                      Control0..1
                                      BindingFor example codes, see BenefitCategoryCodes
                                      (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                      Benefit categories such as: oral-basic, major, glasses.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      752. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.category.id
                                      Definition

                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      This element is affected by the following invariants: ele-1
                                      Typeid
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      754. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.category.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                      ShortAdditional content defined by implementations
                                      Comments

                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                      Control0..*
                                      TypeExtension
                                      Is Modifierfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • value @ url
                                      • 756. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.category.coding
                                        Definition

                                        A reference to a code defined by a terminology system.

                                        ShortCode defined by a terminology system
                                        Comments

                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                        Control1..*
                                        BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                        (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                        TypeCoding
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                        Pattern Value{
                                          "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                          "code" : "SCULK"
                                        }
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        758. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.category.text
                                        Definition

                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                        ShortPlain text representation of the concept
                                        Comments

                                        Very often the text is the same as a displayName of one of the codings.

                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        760. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.productOrService
                                        Definition

                                        When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                        ShortBilling, service, product, or drug code
                                        Comments

                                        If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                        Control0..1
                                        BindingFor example codes, see USCLSCodes
                                        (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                        Allowable service and product codes.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Necessary to state what was provided or done.

                                        Alternate NamesDrug Code, Bill Code, Service Code
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        762. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.productOrServiceEnd
                                        Definition

                                        This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                        ShortEnd of a range of codes
                                        Control0..1
                                        BindingFor example codes, see USCLSCodes
                                        (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        764. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.request
                                        Definition

                                        Request or Referral for Goods or Service to be rendered.

                                        ShortRequest or Referral for Service
                                        Control0..*
                                        TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        May identify the service to be provided or provider authorization for the service.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        766. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.modifier
                                        Definition

                                        Item typification or modifiers codes to convey additional context for the product or service.

                                        ShortProduct or service billing modifiers
                                        Comments

                                        For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.

                                        Control0..*
                                        BindingFor example codes, see ModifierTypeCodes
                                        (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                        Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        To support inclusion of the item for adjudication or to charge an elevated fee.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        768. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.programCode
                                        Definition

                                        Identifies the program under which this may be recovered.

                                        ShortProgram the product or service is provided under
                                        Comments

                                        For example: Neonatal program, child dental program or drug users recovery program.

                                        Control0..*
                                        BindingFor example codes, see ExampleProgramReasonCodes
                                        (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                        Program specific reason codes.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        770. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.serviced[x]
                                        Definition

                                        The date or dates when the service or product was supplied, performed or completed.

                                        ShortDate or dates of service or product delivery
                                        Control0..1
                                        TypeChoice of: date, Period
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        772. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.location[x]
                                        Definition

                                        Where the product or service was provided.

                                        ShortPlace of service or where product was supplied
                                        Control0..1
                                        BindingFor example codes, see ExampleServicePlaceCodes
                                        (example to http://hl7.org/fhir/ValueSet/service-place|5.0.0)

                                        Place of service: pharmacy, school, prison, etc.

                                        TypeChoice of: CodeableConcept, Address, Reference(Location)
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        774. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.patientPaid
                                        Definition

                                        The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                        ShortPaid by the patient
                                        Control0..1
                                        TypeMoney
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        776. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity
                                        Definition

                                        The number of repetitions of a service or product.

                                        ShortPunkteanzahl
                                        Control1..1
                                        TypeQuantity(SimpleQuantity)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Required when the product or service code does not convey the quantity provided.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        778. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.id
                                        Definition

                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        This element is affected by the following invariants: ele-1
                                        Typeid
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        780. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.extension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                        ShortAdditional content defined by implementations
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 782. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.value
                                          Definition

                                          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                          ShortNumerical value (with implicit precision)
                                          Comments

                                          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                          Control1..1
                                          Typedecimal
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Requirements

                                          Precision is handled implicitly in almost all cases of measurement.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          784. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.comparator
                                          Definition

                                          Not allowed to be used in this context

                                          Short< | <= | >= | > | ad - how to understand the value
                                          Control0..0
                                          BindingThe codes SHALL be taken from QuantityComparator
                                          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                          How the Quantity should be understood and represented.

                                          Typecode
                                          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Requirements

                                          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                          Meaning if MissingIf there is no comparator, then there is no modification of the value
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          786. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.unit
                                          Definition

                                          A human-readable form of the unit.

                                          ShortUnit representation
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Requirements

                                          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                          Pattern ValueLKF Punkte
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          788. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.system
                                          Definition

                                          The identification of the system that provides the coded form of the unit.

                                          ShortSystem that defines coded unit form
                                          Control0..1
                                          This element is affected by the following invariants: qty-3
                                          Typeuri
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Requirements

                                          Need to know the system that defines the coded form of the unit.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          790. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.quantity.code
                                          Definition

                                          A computer processable form of the unit in some unit representation system.

                                          ShortCoded form of the unit
                                          Comments

                                          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                          Control0..1
                                          This element is affected by the following invariants: qty-3
                                          Typecode
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summarytrue
                                          Requirements

                                          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          792. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.unitPrice
                                          Definition

                                          If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                          ShortFee, charge or cost per item
                                          Control0..1
                                          TypeMoney
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          The amount charged to the patient by the provider for a single unit.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          794. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.factor
                                          Definition

                                          A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                          ShortPrice scaling factor
                                          Comments

                                          To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                          Control0..1
                                          Typedecimal
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          796. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.tax
                                          Definition

                                          The total of taxes applicable for this product or service.

                                          ShortTotal tax
                                          Control0..1
                                          TypeMoney
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Required when taxes are not embedded in the unit price or provided as a separate service.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          798. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.net
                                          Definition

                                          The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                          ShortTotal item cost
                                          Comments

                                          For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                          Control0..1
                                          TypeMoney
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Provides the total amount claimed for the group (if a grouper) or the line item.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          800. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.udi
                                          Definition

                                          Unique Device Identifiers associated with this line item.

                                          ShortUnique device identifier
                                          Control0..*
                                          TypeReference(Device)
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          The UDI code allows the insurer to obtain device level information on the product supplied.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          802. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.bodySite
                                          Definition

                                          Physical location where the service is performed or applies.

                                          ShortAnatomical location
                                          Control0..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          804. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.bodySite.id
                                          Definition

                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          806. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.bodySite.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          808. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.bodySite.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          810. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.bodySite.site
                                          Definition

                                          Physical service site on the patient (limb, tooth, etc.).

                                          ShortLocation
                                          Comments

                                          For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                          Control1..*
                                          BindingFor example codes, see OralSiteCodes
                                          (example to http://hl7.org/fhir/ValueSet/tooth|5.0.0)
                                          TypeCodeableReference(BodyStructure)
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Allows insurer to validate specific procedures.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          812. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.bodySite.subSite
                                          Definition

                                          A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                          ShortSub-location
                                          Control0..*
                                          BindingFor example codes, see SurfaceCodes
                                          (example to http://hl7.org/fhir/ValueSet/surface|5.0.0)
                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Allows insurer to validate specific procedures.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          814. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.encounter
                                          Definition

                                          Healthcare encounters related to this claim.

                                          ShortEncounters associated with the listed treatments
                                          Comments

                                          This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                                          Control0..*
                                          TypeReference(Encounter)
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Used in some jurisdictions to link clinical events to claim items.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          816. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail
                                          Definition

                                          A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                          ShortProduct or service provided
                                          Control0..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          The items to be processed for adjudication.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          818. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.id
                                          Definition

                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          820. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          822. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          824. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.sequence
                                          Definition

                                          A number to uniquely identify item entries.

                                          ShortItem instance identifier
                                          Control1..1
                                          TypepositiveInt
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          826. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.traceNumber
                                          Definition

                                          Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                          ShortNumber for tracking
                                          Control0..*
                                          TypeIdentifier
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Allows partners to uniquely identify components for tracking.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          828. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.revenue
                                          Definition

                                          The type of revenue or cost center providing the product and/or service.

                                          ShortRevenue or cost center code
                                          Control0..1
                                          BindingFor example codes, see ExampleRevenueCenterCodes
                                          (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                          Codes for the revenue or cost centers supplying the service and/or products.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Needed in the processing of institutional claims.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          830. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.category
                                          Definition

                                          Code to identify the general type of benefits under which products and services are provided.

                                          ShortBenefit classification
                                          Comments

                                          Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                          Control0..1
                                          BindingFor example codes, see BenefitCategoryCodes
                                          (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                          Benefit categories such as: oral-basic, major, glasses.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          832. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.productOrService
                                          Definition

                                          When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                          ShortBilling, service, product, or drug code
                                          Comments

                                          If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                          Control0..1
                                          BindingFor example codes, see USCLSCodes
                                          (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                          Allowable service and product codes.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Necessary to state what was provided or done.

                                          Alternate NamesDrug Code, Bill Code, Service Code
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          834. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.productOrServiceEnd
                                          Definition

                                          This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                          ShortEnd of a range of codes
                                          Control0..1
                                          BindingFor example codes, see USCLSCodes
                                          (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          836. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.modifier
                                          Definition

                                          Item typification or modifiers codes to convey additional context for the product or service.

                                          ShortService/Product billing modifiers
                                          Comments

                                          For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                          Control0..*
                                          BindingFor example codes, see ModifierTypeCodes
                                          (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                          Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          To support inclusion of the item for adjudication or to charge an elevated fee.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          838. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.programCode
                                          Definition

                                          Identifies the program under which this may be recovered.

                                          ShortProgram the product or service is provided under
                                          Comments

                                          For example: Neonatal program, child dental program or drug users recovery program.

                                          Control0..*
                                          BindingFor example codes, see ExampleProgramReasonCodes
                                          (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                          Program specific reason codes.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          840. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.patientPaid
                                          Definition

                                          The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                          ShortPaid by the patient
                                          Control0..1
                                          TypeMoney
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          842. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.quantity
                                          Definition

                                          The number of repetitions of a service or product.

                                          ShortCount of products or services
                                          Control0..1
                                          TypeQuantity(SimpleQuantity)
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Required when the product or service code does not convey the quantity provided.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          844. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.unitPrice
                                          Definition

                                          If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                          ShortFee, charge or cost per item
                                          Control0..1
                                          TypeMoney
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          The amount charged to the patient by the provider for a single unit.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          846. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.factor
                                          Definition

                                          A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                          ShortPrice scaling factor
                                          Comments

                                          To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                          Control0..1
                                          Typedecimal
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          848. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.tax
                                          Definition

                                          The total of taxes applicable for this product or service.

                                          ShortTotal tax
                                          Control0..1
                                          TypeMoney
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Required when taxes are not embedded in the unit price or provided as a separate service.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          850. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.net
                                          Definition

                                          The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                          ShortTotal item cost
                                          Comments

                                          For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                          Control0..1
                                          TypeMoney
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Provides the total amount claimed for the group (if a grouper) or the line item.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          852. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.udi
                                          Definition

                                          Unique Device Identifiers associated with this line item.

                                          ShortUnique device identifier
                                          Control0..*
                                          TypeReference(Device)
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          The UDI code allows the insurer to obtain device level information on the product supplied.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          854. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail
                                          Definition

                                          A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                          ShortProduct or service provided
                                          Control0..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          The items to be processed for adjudication.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          856. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.id
                                          Definition

                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          858. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          860. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          862. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.sequence
                                          Definition

                                          A number to uniquely identify item entries.

                                          ShortItem instance identifier
                                          Control1..1
                                          TypepositiveInt
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          864. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.traceNumber
                                          Definition

                                          Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                          ShortNumber for tracking
                                          Control0..*
                                          TypeIdentifier
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Allows partners to uniquely identify components for tracking.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          866. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.revenue
                                          Definition

                                          The type of revenue or cost center providing the product and/or service.

                                          ShortRevenue or cost center code
                                          Control0..1
                                          BindingFor example codes, see ExampleRevenueCenterCodes
                                          (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                          Codes for the revenue or cost centers supplying the service and/or products.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Needed in the processing of institutional claims.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          868. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.category
                                          Definition

                                          Code to identify the general type of benefits under which products and services are provided.

                                          ShortBenefit classification
                                          Comments

                                          Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                          Control0..1
                                          BindingFor example codes, see BenefitCategoryCodes
                                          (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                          Benefit categories such as: oral-basic, major, glasses.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          870. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.productOrService
                                          Definition

                                          When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                          ShortBilling, service, product, or drug code
                                          Comments

                                          If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                          Control0..1
                                          BindingFor example codes, see USCLSCodes
                                          (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                          Allowable service and product codes.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Necessary to state what was provided or done.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          872. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.productOrServiceEnd
                                          Definition

                                          This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                          ShortEnd of a range of codes
                                          Control0..1
                                          BindingFor example codes, see USCLSCodes
                                          (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          874. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.modifier
                                          Definition

                                          Item typification or modifiers codes to convey additional context for the product or service.

                                          ShortService/Product billing modifiers
                                          Comments

                                          For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                          Control0..*
                                          BindingFor example codes, see ModifierTypeCodes
                                          (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                          Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          To support inclusion of the item for adjudication or to charge an elevated fee.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          876. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.programCode
                                          Definition

                                          Identifies the program under which this may be recovered.

                                          ShortProgram the product or service is provided under
                                          Comments

                                          For example: Neonatal program, child dental program or drug users recovery program.

                                          Control0..*
                                          BindingFor example codes, see ExampleProgramReasonCodes
                                          (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                          Program specific reason codes.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          878. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.patientPaid
                                          Definition

                                          The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                          ShortPaid by the patient
                                          Control0..1
                                          TypeMoney
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          880. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.quantity
                                          Definition

                                          The number of repetitions of a service or product.

                                          ShortCount of products or services
                                          Control0..1
                                          TypeQuantity(SimpleQuantity)
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Required when the product or service code does not convey the quantity provided.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          882. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.unitPrice
                                          Definition

                                          If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                          ShortFee, charge or cost per item
                                          Control0..1
                                          TypeMoney
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          The amount charged to the patient by the provider for a single unit.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          884. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.factor
                                          Definition

                                          A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                          ShortPrice scaling factor
                                          Comments

                                          To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                          Control0..1
                                          Typedecimal
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          886. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.tax
                                          Definition

                                          The total of taxes applicable for this product or service.

                                          ShortTotal tax
                                          Control0..1
                                          TypeMoney
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Required when taxes are not embedded in the unit price or provided as a separate service.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          888. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.net
                                          Definition

                                          The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                          ShortTotal item cost
                                          Comments

                                          For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                          Control0..1
                                          TypeMoney
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Provides the total amount claimed for the group (if a grouper) or the line item.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          890. Claim.item:PunkteBelagsdauerausreisserUntenLeistungskomponente.detail.subDetail.udi
                                          Definition

                                          Unique Device Identifiers associated with this line item.

                                          ShortUnique device identifier
                                          Control0..*
                                          TypeReference(Device)
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          The UDI code allows the insurer to obtain device level information on the product supplied.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          892. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente
                                          Slice NamePunkteBelagsdauerausreisserUntenTageskomponente
                                          Definition

                                          A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

                                          ShortProduct or service provided
                                          Control0..1
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          The items to be processed for adjudication.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          894. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.id
                                          Definition

                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          896. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          898. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          900. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.sequence
                                          Definition

                                          A number to uniquely identify item entries.

                                          ShortItem instance identifier
                                          Control1..1
                                          TypepositiveInt
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          902. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.traceNumber
                                          Definition

                                          Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                          ShortNumber for tracking
                                          Control0..*
                                          TypeIdentifier
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Allows partners to uniquely identify components for tracking.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          904. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.careTeamSequence
                                          Definition

                                          CareTeam members related to this service or product.

                                          ShortApplicable careTeam members
                                          Control0..*
                                          TypepositiveInt
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Need to identify the individuals and their roles in the provision of the product or service.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          906. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.diagnosisSequence
                                          Definition

                                          Diagnosis applicable for this service or product.

                                          ShortApplicable diagnoses
                                          Control0..*
                                          TypepositiveInt
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Need to related the product or service to the associated diagnoses.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          908. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.procedureSequence
                                          Definition

                                          Procedures applicable for this service or product.

                                          ShortApplicable procedures
                                          Control0..*
                                          TypepositiveInt
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Need to provide any listed specific procedures to support the product or service being claimed.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          910. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.informationSequence
                                          Definition

                                          Exceptions, special conditions and supporting information applicable for this service or product.

                                          ShortApplicable exception and supporting information
                                          Control0..*
                                          TypepositiveInt
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Need to reference the supporting information items that relate directly to this product or service.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          912. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.revenue
                                          Definition

                                          The type of revenue or cost center providing the product and/or service.

                                          ShortRevenue or cost center code
                                          Control0..1
                                          BindingFor example codes, see ExampleRevenueCenterCodes
                                          (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                          Codes for the revenue or cost centers supplying the service and/or products.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Needed in the processing of institutional claims.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          914. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.category
                                          Definition

                                          Code to identify the general type of benefits under which products and services are provided.

                                          ShortBenefit classification
                                          Comments

                                          Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                          Control0..1
                                          BindingFor example codes, see BenefitCategoryCodes
                                          (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                          Benefit categories such as: oral-basic, major, glasses.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supportfalse
                                          Summaryfalse
                                          Requirements

                                          Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          916. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.category.id
                                          Definition

                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          This element is affected by the following invariants: ele-1
                                          Typeid
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          918. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.category.extension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                          ShortAdditional content defined by implementations
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Alternate Namesextensions, user content
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 920. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.category.coding
                                            Definition

                                            A reference to a code defined by a terminology system.

                                            ShortCode defined by a terminology system
                                            Comments

                                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                            Control1..*
                                            BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                            (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                            TypeCoding
                                            Is Modifierfalse
                                            Summarytrue
                                            Requirements

                                            Allows for alternative encodings within a code system, and translations to other code systems.

                                            Pattern Value{
                                              "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                              "code" : "SCUTK"
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            922. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.category.text
                                            Definition

                                            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                            ShortPlain text representation of the concept
                                            Comments

                                            Very often the text is the same as a displayName of one of the codings.

                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Requirements

                                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            924. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.productOrService
                                            Definition

                                            When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                            ShortBilling, service, product, or drug code
                                            Comments

                                            If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                            Control0..1
                                            BindingFor example codes, see USCLSCodes
                                            (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                            Allowable service and product codes.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Necessary to state what was provided or done.

                                            Alternate NamesDrug Code, Bill Code, Service Code
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            926. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.productOrServiceEnd
                                            Definition

                                            This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                            ShortEnd of a range of codes
                                            Control0..1
                                            BindingFor example codes, see USCLSCodes
                                            (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            928. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.request
                                            Definition

                                            Request or Referral for Goods or Service to be rendered.

                                            ShortRequest or Referral for Service
                                            Control0..*
                                            TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            May identify the service to be provided or provider authorization for the service.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            930. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.modifier
                                            Definition

                                            Item typification or modifiers codes to convey additional context for the product or service.

                                            ShortProduct or service billing modifiers
                                            Comments

                                            For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.

                                            Control0..*
                                            BindingFor example codes, see ModifierTypeCodes
                                            (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                            Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            To support inclusion of the item for adjudication or to charge an elevated fee.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            932. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.programCode
                                            Definition

                                            Identifies the program under which this may be recovered.

                                            ShortProgram the product or service is provided under
                                            Comments

                                            For example: Neonatal program, child dental program or drug users recovery program.

                                            Control0..*
                                            BindingFor example codes, see ExampleProgramReasonCodes
                                            (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                            Program specific reason codes.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            934. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.serviced[x]
                                            Definition

                                            The date or dates when the service or product was supplied, performed or completed.

                                            ShortDate or dates of service or product delivery
                                            Control0..1
                                            TypeChoice of: date, Period
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            936. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.location[x]
                                            Definition

                                            Where the product or service was provided.

                                            ShortPlace of service or where product was supplied
                                            Control0..1
                                            BindingFor example codes, see ExampleServicePlaceCodes
                                            (example to http://hl7.org/fhir/ValueSet/service-place|5.0.0)

                                            Place of service: pharmacy, school, prison, etc.

                                            TypeChoice of: CodeableConcept, Address, Reference(Location)
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            938. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.patientPaid
                                            Definition

                                            The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                            ShortPaid by the patient
                                            Control0..1
                                            TypeMoney
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            940. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity
                                            Definition

                                            The number of repetitions of a service or product.

                                            ShortPunkteanzahl
                                            Control1..1
                                            TypeQuantity(SimpleQuantity)
                                            Is Modifierfalse
                                            Must Supportfalse
                                            Summaryfalse
                                            Requirements

                                            Required when the product or service code does not convey the quantity provided.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            942. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.id
                                            Definition

                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            This element is affected by the following invariants: ele-1
                                            Typeid
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            944. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.extension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                            ShortAdditional content defined by implementations
                                            Comments

                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                            Control0..*
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Alternate Namesextensions, user content
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 946. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.value
                                              Definition

                                              The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                              ShortNumerical value (with implicit precision)
                                              Comments

                                              The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                              Control1..1
                                              Typedecimal
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              Precision is handled implicitly in almost all cases of measurement.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              948. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.comparator
                                              Definition

                                              Not allowed to be used in this context

                                              Short< | <= | >= | > | ad - how to understand the value
                                              Control0..0
                                              BindingThe codes SHALL be taken from QuantityComparator
                                              (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                              How the Quantity should be understood and represented.

                                              Typecode
                                              Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                              Meaning if MissingIf there is no comparator, then there is no modification of the value
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              950. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.unit
                                              Definition

                                              A human-readable form of the unit.

                                              ShortUnit representation
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                              Pattern ValueLKF Punkte
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              952. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.system
                                              Definition

                                              The identification of the system that provides the coded form of the unit.

                                              ShortSystem that defines coded unit form
                                              Control0..1
                                              This element is affected by the following invariants: qty-3
                                              Typeuri
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              Need to know the system that defines the coded form of the unit.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              954. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.quantity.code
                                              Definition

                                              A computer processable form of the unit in some unit representation system.

                                              ShortCoded form of the unit
                                              Comments

                                              The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                              Control0..1
                                              This element is affected by the following invariants: qty-3
                                              Typecode
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              956. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.unitPrice
                                              Definition

                                              If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                              ShortFee, charge or cost per item
                                              Control0..1
                                              TypeMoney
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              The amount charged to the patient by the provider for a single unit.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              958. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.factor
                                              Definition

                                              A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                              ShortPrice scaling factor
                                              Comments

                                              To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                              Control0..1
                                              Typedecimal
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              960. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.tax
                                              Definition

                                              The total of taxes applicable for this product or service.

                                              ShortTotal tax
                                              Control0..1
                                              TypeMoney
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Required when taxes are not embedded in the unit price or provided as a separate service.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              962. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.net
                                              Definition

                                              The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                              ShortTotal item cost
                                              Comments

                                              For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                              Control0..1
                                              TypeMoney
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Provides the total amount claimed for the group (if a grouper) or the line item.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              964. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.udi
                                              Definition

                                              Unique Device Identifiers associated with this line item.

                                              ShortUnique device identifier
                                              Control0..*
                                              TypeReference(Device)
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              The UDI code allows the insurer to obtain device level information on the product supplied.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              966. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.bodySite
                                              Definition

                                              Physical location where the service is performed or applies.

                                              ShortAnatomical location
                                              Control0..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              968. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.bodySite.id
                                              Definition

                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              970. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.bodySite.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              972. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.bodySite.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              974. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.bodySite.site
                                              Definition

                                              Physical service site on the patient (limb, tooth, etc.).

                                              ShortLocation
                                              Comments

                                              For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                              Control1..*
                                              BindingFor example codes, see OralSiteCodes
                                              (example to http://hl7.org/fhir/ValueSet/tooth|5.0.0)
                                              TypeCodeableReference(BodyStructure)
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Allows insurer to validate specific procedures.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              976. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.bodySite.subSite
                                              Definition

                                              A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                              ShortSub-location
                                              Control0..*
                                              BindingFor example codes, see SurfaceCodes
                                              (example to http://hl7.org/fhir/ValueSet/surface|5.0.0)
                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Allows insurer to validate specific procedures.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              978. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.encounter
                                              Definition

                                              Healthcare encounters related to this claim.

                                              ShortEncounters associated with the listed treatments
                                              Comments

                                              This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                                              Control0..*
                                              TypeReference(Encounter)
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Used in some jurisdictions to link clinical events to claim items.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              980. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail
                                              Definition

                                              A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                              ShortProduct or service provided
                                              Control0..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              The items to be processed for adjudication.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              982. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.id
                                              Definition

                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              984. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              986. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              988. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.sequence
                                              Definition

                                              A number to uniquely identify item entries.

                                              ShortItem instance identifier
                                              Control1..1
                                              TypepositiveInt
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              990. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.traceNumber
                                              Definition

                                              Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                              ShortNumber for tracking
                                              Control0..*
                                              TypeIdentifier
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Allows partners to uniquely identify components for tracking.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              992. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.revenue
                                              Definition

                                              The type of revenue or cost center providing the product and/or service.

                                              ShortRevenue or cost center code
                                              Control0..1
                                              BindingFor example codes, see ExampleRevenueCenterCodes
                                              (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                              Codes for the revenue or cost centers supplying the service and/or products.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Needed in the processing of institutional claims.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              994. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.category
                                              Definition

                                              Code to identify the general type of benefits under which products and services are provided.

                                              ShortBenefit classification
                                              Comments

                                              Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                              Control0..1
                                              BindingFor example codes, see BenefitCategoryCodes
                                              (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                              Benefit categories such as: oral-basic, major, glasses.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              996. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.productOrService
                                              Definition

                                              When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                              ShortBilling, service, product, or drug code
                                              Comments

                                              If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                              Control0..1
                                              BindingFor example codes, see USCLSCodes
                                              (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                              Allowable service and product codes.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Necessary to state what was provided or done.

                                              Alternate NamesDrug Code, Bill Code, Service Code
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              998. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.productOrServiceEnd
                                              Definition

                                              This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                              ShortEnd of a range of codes
                                              Control0..1
                                              BindingFor example codes, see USCLSCodes
                                              (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1000. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.modifier
                                              Definition

                                              Item typification or modifiers codes to convey additional context for the product or service.

                                              ShortService/Product billing modifiers
                                              Comments

                                              For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                              Control0..*
                                              BindingFor example codes, see ModifierTypeCodes
                                              (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                              Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              To support inclusion of the item for adjudication or to charge an elevated fee.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1002. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.programCode
                                              Definition

                                              Identifies the program under which this may be recovered.

                                              ShortProgram the product or service is provided under
                                              Comments

                                              For example: Neonatal program, child dental program or drug users recovery program.

                                              Control0..*
                                              BindingFor example codes, see ExampleProgramReasonCodes
                                              (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                              Program specific reason codes.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1004. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.patientPaid
                                              Definition

                                              The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                              ShortPaid by the patient
                                              Control0..1
                                              TypeMoney
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1006. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.quantity
                                              Definition

                                              The number of repetitions of a service or product.

                                              ShortCount of products or services
                                              Control0..1
                                              TypeQuantity(SimpleQuantity)
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Required when the product or service code does not convey the quantity provided.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1008. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.unitPrice
                                              Definition

                                              If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                              ShortFee, charge or cost per item
                                              Control0..1
                                              TypeMoney
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              The amount charged to the patient by the provider for a single unit.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1010. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.factor
                                              Definition

                                              A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                              ShortPrice scaling factor
                                              Comments

                                              To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                              Control0..1
                                              Typedecimal
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1012. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.tax
                                              Definition

                                              The total of taxes applicable for this product or service.

                                              ShortTotal tax
                                              Control0..1
                                              TypeMoney
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Required when taxes are not embedded in the unit price or provided as a separate service.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1014. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.net
                                              Definition

                                              The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                              ShortTotal item cost
                                              Comments

                                              For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                              Control0..1
                                              TypeMoney
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Provides the total amount claimed for the group (if a grouper) or the line item.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1016. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.udi
                                              Definition

                                              Unique Device Identifiers associated with this line item.

                                              ShortUnique device identifier
                                              Control0..*
                                              TypeReference(Device)
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              The UDI code allows the insurer to obtain device level information on the product supplied.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1018. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail
                                              Definition

                                              A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                              ShortProduct or service provided
                                              Control0..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              The items to be processed for adjudication.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1020. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.id
                                              Definition

                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              1022. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              1024. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              1026. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.sequence
                                              Definition

                                              A number to uniquely identify item entries.

                                              ShortItem instance identifier
                                              Control1..1
                                              TypepositiveInt
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1028. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.traceNumber
                                              Definition

                                              Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                              ShortNumber for tracking
                                              Control0..*
                                              TypeIdentifier
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Allows partners to uniquely identify components for tracking.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1030. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.revenue
                                              Definition

                                              The type of revenue or cost center providing the product and/or service.

                                              ShortRevenue or cost center code
                                              Control0..1
                                              BindingFor example codes, see ExampleRevenueCenterCodes
                                              (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                              Codes for the revenue or cost centers supplying the service and/or products.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Needed in the processing of institutional claims.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1032. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.category
                                              Definition

                                              Code to identify the general type of benefits under which products and services are provided.

                                              ShortBenefit classification
                                              Comments

                                              Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                              Control0..1
                                              BindingFor example codes, see BenefitCategoryCodes
                                              (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                              Benefit categories such as: oral-basic, major, glasses.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1034. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.productOrService
                                              Definition

                                              When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                              ShortBilling, service, product, or drug code
                                              Comments

                                              If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                              Control0..1
                                              BindingFor example codes, see USCLSCodes
                                              (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                              Allowable service and product codes.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Necessary to state what was provided or done.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1036. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.productOrServiceEnd
                                              Definition

                                              This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                              ShortEnd of a range of codes
                                              Control0..1
                                              BindingFor example codes, see USCLSCodes
                                              (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1038. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.modifier
                                              Definition

                                              Item typification or modifiers codes to convey additional context for the product or service.

                                              ShortService/Product billing modifiers
                                              Comments

                                              For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                              Control0..*
                                              BindingFor example codes, see ModifierTypeCodes
                                              (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                              Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              To support inclusion of the item for adjudication or to charge an elevated fee.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1040. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.programCode
                                              Definition

                                              Identifies the program under which this may be recovered.

                                              ShortProgram the product or service is provided under
                                              Comments

                                              For example: Neonatal program, child dental program or drug users recovery program.

                                              Control0..*
                                              BindingFor example codes, see ExampleProgramReasonCodes
                                              (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                              Program specific reason codes.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1042. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.patientPaid
                                              Definition

                                              The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                              ShortPaid by the patient
                                              Control0..1
                                              TypeMoney
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1044. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.quantity
                                              Definition

                                              The number of repetitions of a service or product.

                                              ShortCount of products or services
                                              Control0..1
                                              TypeQuantity(SimpleQuantity)
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Required when the product or service code does not convey the quantity provided.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1046. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.unitPrice
                                              Definition

                                              If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                              ShortFee, charge or cost per item
                                              Control0..1
                                              TypeMoney
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              The amount charged to the patient by the provider for a single unit.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1048. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.factor
                                              Definition

                                              A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                              ShortPrice scaling factor
                                              Comments

                                              To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                              Control0..1
                                              Typedecimal
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1050. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.tax
                                              Definition

                                              The total of taxes applicable for this product or service.

                                              ShortTotal tax
                                              Control0..1
                                              TypeMoney
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Required when taxes are not embedded in the unit price or provided as a separate service.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1052. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.net
                                              Definition

                                              The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                              ShortTotal item cost
                                              Comments

                                              For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                              Control0..1
                                              TypeMoney
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Provides the total amount claimed for the group (if a grouper) or the line item.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1054. Claim.item:PunkteBelagsdauerausreisserUntenTageskomponente.detail.subDetail.udi
                                              Definition

                                              Unique Device Identifiers associated with this line item.

                                              ShortUnique device identifier
                                              Control0..*
                                              TypeReference(Device)
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              The UDI code allows the insurer to obtain device level information on the product supplied.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1056. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben
                                              Slice NameZusatzpunkteBelagsdauerausreisserNachOben
                                              Definition

                                              A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

                                              ShortProduct or service provided
                                              Control0..1
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              The items to be processed for adjudication.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1058. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.id
                                              Definition

                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              1060. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              1062. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              1064. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.sequence
                                              Definition

                                              A number to uniquely identify item entries.

                                              ShortItem instance identifier
                                              Control1..1
                                              TypepositiveInt
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1066. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.traceNumber
                                              Definition

                                              Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                              ShortNumber for tracking
                                              Control0..*
                                              TypeIdentifier
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Allows partners to uniquely identify components for tracking.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1068. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.careTeamSequence
                                              Definition

                                              CareTeam members related to this service or product.

                                              ShortApplicable careTeam members
                                              Control0..*
                                              TypepositiveInt
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Need to identify the individuals and their roles in the provision of the product or service.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1070. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.diagnosisSequence
                                              Definition

                                              Diagnosis applicable for this service or product.

                                              ShortApplicable diagnoses
                                              Control0..*
                                              TypepositiveInt
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Need to related the product or service to the associated diagnoses.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1072. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.procedureSequence
                                              Definition

                                              Procedures applicable for this service or product.

                                              ShortApplicable procedures
                                              Control0..*
                                              TypepositiveInt
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Need to provide any listed specific procedures to support the product or service being claimed.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1074. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.informationSequence
                                              Definition

                                              Exceptions, special conditions and supporting information applicable for this service or product.

                                              ShortApplicable exception and supporting information
                                              Control0..*
                                              TypepositiveInt
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Need to reference the supporting information items that relate directly to this product or service.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1076. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.revenue
                                              Definition

                                              The type of revenue or cost center providing the product and/or service.

                                              ShortRevenue or cost center code
                                              Control0..1
                                              BindingFor example codes, see ExampleRevenueCenterCodes
                                              (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                              Codes for the revenue or cost centers supplying the service and/or products.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Needed in the processing of institutional claims.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1078. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.category
                                              Definition

                                              Code to identify the general type of benefits under which products and services are provided.

                                              ShortBenefit classification
                                              Comments

                                              Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                              Control0..1
                                              BindingFor example codes, see BenefitCategoryCodes
                                              (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                              Benefit categories such as: oral-basic, major, glasses.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Summaryfalse
                                              Requirements

                                              Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              1080. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.category.id
                                              Definition

                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              This element is affected by the following invariants: ele-1
                                              Typeid
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              1082. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.category.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 1084. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.category.coding
                                                Definition

                                                A reference to a code defined by a terminology system.

                                                ShortCode defined by a terminology system
                                                Comments

                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                Control1..*
                                                BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                                (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                                TypeCoding
                                                Is Modifierfalse
                                                Summarytrue
                                                Requirements

                                                Allows for alternative encodings within a code system, and translations to other code systems.

                                                Pattern Value{
                                                  "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                                  "code" : "BDZU"
                                                }
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                1086. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.category.text
                                                Definition

                                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                ShortPlain text representation of the concept
                                                Comments

                                                Very often the text is the same as a displayName of one of the codings.

                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summarytrue
                                                Requirements

                                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                1088. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.productOrService
                                                Definition

                                                When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                                ShortBilling, service, product, or drug code
                                                Comments

                                                If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                Control0..1
                                                BindingFor example codes, see USCLSCodes
                                                (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                                Allowable service and product codes.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Necessary to state what was provided or done.

                                                Alternate NamesDrug Code, Bill Code, Service Code
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                1090. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.productOrServiceEnd
                                                Definition

                                                This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                                ShortEnd of a range of codes
                                                Control0..1
                                                BindingFor example codes, see USCLSCodes
                                                (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                1092. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.request
                                                Definition

                                                Request or Referral for Goods or Service to be rendered.

                                                ShortRequest or Referral for Service
                                                Control0..*
                                                TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                May identify the service to be provided or provider authorization for the service.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                1094. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.modifier
                                                Definition

                                                Item typification or modifiers codes to convey additional context for the product or service.

                                                ShortProduct or service billing modifiers
                                                Comments

                                                For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.

                                                Control0..*
                                                BindingFor example codes, see ModifierTypeCodes
                                                (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                                Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                To support inclusion of the item for adjudication or to charge an elevated fee.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                1096. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.programCode
                                                Definition

                                                Identifies the program under which this may be recovered.

                                                ShortProgram the product or service is provided under
                                                Comments

                                                For example: Neonatal program, child dental program or drug users recovery program.

                                                Control0..*
                                                BindingFor example codes, see ExampleProgramReasonCodes
                                                (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                                Program specific reason codes.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                1098. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.serviced[x]
                                                Definition

                                                The date or dates when the service or product was supplied, performed or completed.

                                                ShortDate or dates of service or product delivery
                                                Control0..1
                                                TypeChoice of: date, Period
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                1100. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.location[x]
                                                Definition

                                                Where the product or service was provided.

                                                ShortPlace of service or where product was supplied
                                                Control0..1
                                                BindingFor example codes, see ExampleServicePlaceCodes
                                                (example to http://hl7.org/fhir/ValueSet/service-place|5.0.0)

                                                Place of service: pharmacy, school, prison, etc.

                                                TypeChoice of: CodeableConcept, Address, Reference(Location)
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                1102. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.patientPaid
                                                Definition

                                                The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                                ShortPaid by the patient
                                                Control0..1
                                                TypeMoney
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                1104. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity
                                                Definition

                                                The number of repetitions of a service or product.

                                                ShortPunkteanzahl
                                                Control1..1
                                                TypeQuantity(SimpleQuantity)
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Summaryfalse
                                                Requirements

                                                Required when the product or service code does not convey the quantity provided.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                1106. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.id
                                                Definition

                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                This element is affected by the following invariants: ele-1
                                                Typeid
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                1108. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.extension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                ShortAdditional content defined by implementations
                                                Comments

                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                Control0..*
                                                TypeExtension
                                                Is Modifierfalse
                                                Summaryfalse
                                                Alternate Namesextensions, user content
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • value @ url
                                                • 1110. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.value
                                                  Definition

                                                  The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                  ShortNumerical value (with implicit precision)
                                                  Comments

                                                  The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                  Control1..1
                                                  Typedecimal
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

                                                  Precision is handled implicitly in almost all cases of measurement.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1112. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.comparator
                                                  Definition

                                                  Not allowed to be used in this context

                                                  Short< | <= | >= | > | ad - how to understand the value
                                                  Control0..0
                                                  BindingThe codes SHALL be taken from QuantityComparator
                                                  (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                                  How the Quantity should be understood and represented.

                                                  Typecode
                                                  Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

                                                  Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                  Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1114. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.unit
                                                  Definition

                                                  A human-readable form of the unit.

                                                  ShortUnit representation
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

                                                  There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                  Pattern ValueLKF Punkte
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1116. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.system
                                                  Definition

                                                  The identification of the system that provides the coded form of the unit.

                                                  ShortSystem that defines coded unit form
                                                  Control0..1
                                                  This element is affected by the following invariants: qty-3
                                                  Typeuri
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

                                                  Need to know the system that defines the coded form of the unit.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1118. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.quantity.code
                                                  Definition

                                                  A computer processable form of the unit in some unit representation system.

                                                  ShortCoded form of the unit
                                                  Comments

                                                  The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                  Control0..1
                                                  This element is affected by the following invariants: qty-3
                                                  Typecode
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Requirements

                                                  Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1120. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.unitPrice
                                                  Definition

                                                  If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                  ShortFee, charge or cost per item
                                                  Control0..1
                                                  TypeMoney
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  The amount charged to the patient by the provider for a single unit.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1122. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.factor
                                                  Definition

                                                  A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                  ShortPrice scaling factor
                                                  Comments

                                                  To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                  Control0..1
                                                  Typedecimal
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1124. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.tax
                                                  Definition

                                                  The total of taxes applicable for this product or service.

                                                  ShortTotal tax
                                                  Control0..1
                                                  TypeMoney
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Required when taxes are not embedded in the unit price or provided as a separate service.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1126. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.net
                                                  Definition

                                                  The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                                  ShortTotal item cost
                                                  Comments

                                                  For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                  Control0..1
                                                  TypeMoney
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Provides the total amount claimed for the group (if a grouper) or the line item.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1128. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.udi
                                                  Definition

                                                  Unique Device Identifiers associated with this line item.

                                                  ShortUnique device identifier
                                                  Control0..*
                                                  TypeReference(Device)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  The UDI code allows the insurer to obtain device level information on the product supplied.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1130. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.bodySite
                                                  Definition

                                                  Physical location where the service is performed or applies.

                                                  ShortAnatomical location
                                                  Control0..*
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1132. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.bodySite.id
                                                  Definition

                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typestring
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  1134. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.bodySite.extension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                  ShortAdditional content defined by implementations
                                                  Comments

                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Alternate Namesextensions, user content
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  1136. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.bodySite.modifierExtension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                  Comments

                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                  Summarytrue
                                                  Requirements

                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                  Alternate Namesextensions, user content, modifiers
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  1138. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.bodySite.site
                                                  Definition

                                                  Physical service site on the patient (limb, tooth, etc.).

                                                  ShortLocation
                                                  Comments

                                                  For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                                  Control1..*
                                                  BindingFor example codes, see OralSiteCodes
                                                  (example to http://hl7.org/fhir/ValueSet/tooth|5.0.0)
                                                  TypeCodeableReference(BodyStructure)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Allows insurer to validate specific procedures.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1140. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.bodySite.subSite
                                                  Definition

                                                  A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                                  ShortSub-location
                                                  Control0..*
                                                  BindingFor example codes, see SurfaceCodes
                                                  (example to http://hl7.org/fhir/ValueSet/surface|5.0.0)
                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Allows insurer to validate specific procedures.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1142. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.encounter
                                                  Definition

                                                  Healthcare encounters related to this claim.

                                                  ShortEncounters associated with the listed treatments
                                                  Comments

                                                  This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                                                  Control0..*
                                                  TypeReference(Encounter)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Used in some jurisdictions to link clinical events to claim items.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1144. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail
                                                  Definition

                                                  A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                  ShortProduct or service provided
                                                  Control0..*
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  The items to be processed for adjudication.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1146. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.id
                                                  Definition

                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typestring
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  1148. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.extension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                  ShortAdditional content defined by implementations
                                                  Comments

                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Alternate Namesextensions, user content
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  1150. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.modifierExtension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                  Comments

                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                  Summarytrue
                                                  Requirements

                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                  Alternate Namesextensions, user content, modifiers
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  1152. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.sequence
                                                  Definition

                                                  A number to uniquely identify item entries.

                                                  ShortItem instance identifier
                                                  Control1..1
                                                  TypepositiveInt
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1154. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.traceNumber
                                                  Definition

                                                  Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                  ShortNumber for tracking
                                                  Control0..*
                                                  TypeIdentifier
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Allows partners to uniquely identify components for tracking.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1156. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.revenue
                                                  Definition

                                                  The type of revenue or cost center providing the product and/or service.

                                                  ShortRevenue or cost center code
                                                  Control0..1
                                                  BindingFor example codes, see ExampleRevenueCenterCodes
                                                  (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                                  Codes for the revenue or cost centers supplying the service and/or products.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Needed in the processing of institutional claims.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1158. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.category
                                                  Definition

                                                  Code to identify the general type of benefits under which products and services are provided.

                                                  ShortBenefit classification
                                                  Comments

                                                  Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                  Control0..1
                                                  BindingFor example codes, see BenefitCategoryCodes
                                                  (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                                  Benefit categories such as: oral-basic, major, glasses.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1160. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.productOrService
                                                  Definition

                                                  When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                                  ShortBilling, service, product, or drug code
                                                  Comments

                                                  If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                  Control0..1
                                                  BindingFor example codes, see USCLSCodes
                                                  (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                                  Allowable service and product codes.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Necessary to state what was provided or done.

                                                  Alternate NamesDrug Code, Bill Code, Service Code
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1162. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.productOrServiceEnd
                                                  Definition

                                                  This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                                  ShortEnd of a range of codes
                                                  Control0..1
                                                  BindingFor example codes, see USCLSCodes
                                                  (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1164. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.modifier
                                                  Definition

                                                  Item typification or modifiers codes to convey additional context for the product or service.

                                                  ShortService/Product billing modifiers
                                                  Comments

                                                  For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                                  Control0..*
                                                  BindingFor example codes, see ModifierTypeCodes
                                                  (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                                  Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  To support inclusion of the item for adjudication or to charge an elevated fee.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1166. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.programCode
                                                  Definition

                                                  Identifies the program under which this may be recovered.

                                                  ShortProgram the product or service is provided under
                                                  Comments

                                                  For example: Neonatal program, child dental program or drug users recovery program.

                                                  Control0..*
                                                  BindingFor example codes, see ExampleProgramReasonCodes
                                                  (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                                  Program specific reason codes.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1168. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.patientPaid
                                                  Definition

                                                  The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                                  ShortPaid by the patient
                                                  Control0..1
                                                  TypeMoney
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1170. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.quantity
                                                  Definition

                                                  The number of repetitions of a service or product.

                                                  ShortCount of products or services
                                                  Control0..1
                                                  TypeQuantity(SimpleQuantity)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Required when the product or service code does not convey the quantity provided.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1172. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.unitPrice
                                                  Definition

                                                  If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                  ShortFee, charge or cost per item
                                                  Control0..1
                                                  TypeMoney
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  The amount charged to the patient by the provider for a single unit.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1174. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.factor
                                                  Definition

                                                  A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                  ShortPrice scaling factor
                                                  Comments

                                                  To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                  Control0..1
                                                  Typedecimal
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1176. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.tax
                                                  Definition

                                                  The total of taxes applicable for this product or service.

                                                  ShortTotal tax
                                                  Control0..1
                                                  TypeMoney
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Required when taxes are not embedded in the unit price or provided as a separate service.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1178. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.net
                                                  Definition

                                                  The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                                  ShortTotal item cost
                                                  Comments

                                                  For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                  Control0..1
                                                  TypeMoney
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Provides the total amount claimed for the group (if a grouper) or the line item.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1180. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.udi
                                                  Definition

                                                  Unique Device Identifiers associated with this line item.

                                                  ShortUnique device identifier
                                                  Control0..*
                                                  TypeReference(Device)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  The UDI code allows the insurer to obtain device level information on the product supplied.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1182. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail
                                                  Definition

                                                  A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                  ShortProduct or service provided
                                                  Control0..*
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  The items to be processed for adjudication.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1184. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.id
                                                  Definition

                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typestring
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  1186. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.extension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                  ShortAdditional content defined by implementations
                                                  Comments

                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Alternate Namesextensions, user content
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  1188. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.modifierExtension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                  Comments

                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                  Summarytrue
                                                  Requirements

                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                  Alternate Namesextensions, user content, modifiers
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  1190. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.sequence
                                                  Definition

                                                  A number to uniquely identify item entries.

                                                  ShortItem instance identifier
                                                  Control1..1
                                                  TypepositiveInt
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1192. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.traceNumber
                                                  Definition

                                                  Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                  ShortNumber for tracking
                                                  Control0..*
                                                  TypeIdentifier
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Allows partners to uniquely identify components for tracking.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1194. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.revenue
                                                  Definition

                                                  The type of revenue or cost center providing the product and/or service.

                                                  ShortRevenue or cost center code
                                                  Control0..1
                                                  BindingFor example codes, see ExampleRevenueCenterCodes
                                                  (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                                  Codes for the revenue or cost centers supplying the service and/or products.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Needed in the processing of institutional claims.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1196. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.category
                                                  Definition

                                                  Code to identify the general type of benefits under which products and services are provided.

                                                  ShortBenefit classification
                                                  Comments

                                                  Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                  Control0..1
                                                  BindingFor example codes, see BenefitCategoryCodes
                                                  (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                                  Benefit categories such as: oral-basic, major, glasses.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1198. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.productOrService
                                                  Definition

                                                  When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                                  ShortBilling, service, product, or drug code
                                                  Comments

                                                  If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                  Control0..1
                                                  BindingFor example codes, see USCLSCodes
                                                  (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                                  Allowable service and product codes.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Necessary to state what was provided or done.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1200. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.productOrServiceEnd
                                                  Definition

                                                  This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                                  ShortEnd of a range of codes
                                                  Control0..1
                                                  BindingFor example codes, see USCLSCodes
                                                  (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1202. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.modifier
                                                  Definition

                                                  Item typification or modifiers codes to convey additional context for the product or service.

                                                  ShortService/Product billing modifiers
                                                  Comments

                                                  For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                                  Control0..*
                                                  BindingFor example codes, see ModifierTypeCodes
                                                  (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                                  Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  To support inclusion of the item for adjudication or to charge an elevated fee.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1204. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.programCode
                                                  Definition

                                                  Identifies the program under which this may be recovered.

                                                  ShortProgram the product or service is provided under
                                                  Comments

                                                  For example: Neonatal program, child dental program or drug users recovery program.

                                                  Control0..*
                                                  BindingFor example codes, see ExampleProgramReasonCodes
                                                  (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                                  Program specific reason codes.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1206. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.patientPaid
                                                  Definition

                                                  The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                                  ShortPaid by the patient
                                                  Control0..1
                                                  TypeMoney
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1208. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.quantity
                                                  Definition

                                                  The number of repetitions of a service or product.

                                                  ShortCount of products or services
                                                  Control0..1
                                                  TypeQuantity(SimpleQuantity)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Required when the product or service code does not convey the quantity provided.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1210. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.unitPrice
                                                  Definition

                                                  If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                  ShortFee, charge or cost per item
                                                  Control0..1
                                                  TypeMoney
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  The amount charged to the patient by the provider for a single unit.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1212. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.factor
                                                  Definition

                                                  A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                  ShortPrice scaling factor
                                                  Comments

                                                  To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                  Control0..1
                                                  Typedecimal
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1214. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.tax
                                                  Definition

                                                  The total of taxes applicable for this product or service.

                                                  ShortTotal tax
                                                  Control0..1
                                                  TypeMoney
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Required when taxes are not embedded in the unit price or provided as a separate service.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1216. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.net
                                                  Definition

                                                  The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                                  ShortTotal item cost
                                                  Comments

                                                  For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                  Control0..1
                                                  TypeMoney
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Provides the total amount claimed for the group (if a grouper) or the line item.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1218. Claim.item:ZusatzpunkteBelagsdauerausreisserNachOben.detail.subDetail.udi
                                                  Definition

                                                  Unique Device Identifiers associated with this line item.

                                                  ShortUnique device identifier
                                                  Control0..*
                                                  TypeReference(Device)
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  The UDI code allows the insurer to obtain device level information on the product supplied.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1220. Claim.item:ZusatzpunkteIntensiv
                                                  Slice NameZusatzpunkteIntensiv
                                                  Definition

                                                  A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

                                                  ShortProduct or service provided
                                                  Control0..1
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  The items to be processed for adjudication.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1222. Claim.item:ZusatzpunkteIntensiv.id
                                                  Definition

                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typestring
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  1224. Claim.item:ZusatzpunkteIntensiv.extension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                  ShortAdditional content defined by implementations
                                                  Comments

                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Alternate Namesextensions, user content
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  1226. Claim.item:ZusatzpunkteIntensiv.modifierExtension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                  Comments

                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                  Summarytrue
                                                  Requirements

                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                  Alternate Namesextensions, user content, modifiers
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  1228. Claim.item:ZusatzpunkteIntensiv.sequence
                                                  Definition

                                                  A number to uniquely identify item entries.

                                                  ShortItem instance identifier
                                                  Control1..1
                                                  TypepositiveInt
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1230. Claim.item:ZusatzpunkteIntensiv.traceNumber
                                                  Definition

                                                  Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                  ShortNumber for tracking
                                                  Control0..*
                                                  TypeIdentifier
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Allows partners to uniquely identify components for tracking.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1232. Claim.item:ZusatzpunkteIntensiv.careTeamSequence
                                                  Definition

                                                  CareTeam members related to this service or product.

                                                  ShortApplicable careTeam members
                                                  Control0..*
                                                  TypepositiveInt
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Need to identify the individuals and their roles in the provision of the product or service.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1234. Claim.item:ZusatzpunkteIntensiv.diagnosisSequence
                                                  Definition

                                                  Diagnosis applicable for this service or product.

                                                  ShortApplicable diagnoses
                                                  Control0..*
                                                  TypepositiveInt
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Need to related the product or service to the associated diagnoses.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1236. Claim.item:ZusatzpunkteIntensiv.procedureSequence
                                                  Definition

                                                  Procedures applicable for this service or product.

                                                  ShortApplicable procedures
                                                  Control0..*
                                                  TypepositiveInt
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Need to provide any listed specific procedures to support the product or service being claimed.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1238. Claim.item:ZusatzpunkteIntensiv.informationSequence
                                                  Definition

                                                  Exceptions, special conditions and supporting information applicable for this service or product.

                                                  ShortApplicable exception and supporting information
                                                  Control0..*
                                                  TypepositiveInt
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Need to reference the supporting information items that relate directly to this product or service.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1240. Claim.item:ZusatzpunkteIntensiv.revenue
                                                  Definition

                                                  The type of revenue or cost center providing the product and/or service.

                                                  ShortRevenue or cost center code
                                                  Control0..1
                                                  BindingFor example codes, see ExampleRevenueCenterCodes
                                                  (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                                  Codes for the revenue or cost centers supplying the service and/or products.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Needed in the processing of institutional claims.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1242. Claim.item:ZusatzpunkteIntensiv.category
                                                  Definition

                                                  Code to identify the general type of benefits under which products and services are provided.

                                                  ShortBenefit classification
                                                  Comments

                                                  Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                  Control0..1
                                                  BindingFor example codes, see BenefitCategoryCodes
                                                  (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                                  Benefit categories such as: oral-basic, major, glasses.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  1244. Claim.item:ZusatzpunkteIntensiv.category.id
                                                  Definition

                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  This element is affected by the following invariants: ele-1
                                                  Typeid
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  1246. Claim.item:ZusatzpunkteIntensiv.category.extension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                  ShortAdditional content defined by implementations
                                                  Comments

                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Alternate Namesextensions, user content
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 1248. Claim.item:ZusatzpunkteIntensiv.category.coding
                                                    Definition

                                                    A reference to a code defined by a terminology system.

                                                    ShortCode defined by a terminology system
                                                    Comments

                                                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                    Control1..*
                                                    BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                                    (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                                    TypeCoding
                                                    Is Modifierfalse
                                                    Summarytrue
                                                    Requirements

                                                    Allows for alternative encodings within a code system, and translations to other code systems.

                                                    Pattern Value{
                                                      "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                                      "code" : "INTZU"
                                                    }
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    1250. Claim.item:ZusatzpunkteIntensiv.category.text
                                                    Definition

                                                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                    ShortPlain text representation of the concept
                                                    Comments

                                                    Very often the text is the same as a displayName of one of the codings.

                                                    Control0..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summarytrue
                                                    Requirements

                                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    1252. Claim.item:ZusatzpunkteIntensiv.productOrService
                                                    Definition

                                                    When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                                    ShortBilling, service, product, or drug code
                                                    Comments

                                                    If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                    Control0..1
                                                    BindingFor example codes, see USCLSCodes
                                                    (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                                    Allowable service and product codes.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Necessary to state what was provided or done.

                                                    Alternate NamesDrug Code, Bill Code, Service Code
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    1254. Claim.item:ZusatzpunkteIntensiv.productOrServiceEnd
                                                    Definition

                                                    This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                                    ShortEnd of a range of codes
                                                    Control0..1
                                                    BindingFor example codes, see USCLSCodes
                                                    (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    1256. Claim.item:ZusatzpunkteIntensiv.request
                                                    Definition

                                                    Request or Referral for Goods or Service to be rendered.

                                                    ShortRequest or Referral for Service
                                                    Control0..*
                                                    TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    May identify the service to be provided or provider authorization for the service.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    1258. Claim.item:ZusatzpunkteIntensiv.modifier
                                                    Definition

                                                    Item typification or modifiers codes to convey additional context for the product or service.

                                                    ShortProduct or service billing modifiers
                                                    Comments

                                                    For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.

                                                    Control0..*
                                                    BindingFor example codes, see ModifierTypeCodes
                                                    (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                                    Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    To support inclusion of the item for adjudication or to charge an elevated fee.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    1260. Claim.item:ZusatzpunkteIntensiv.programCode
                                                    Definition

                                                    Identifies the program under which this may be recovered.

                                                    ShortProgram the product or service is provided under
                                                    Comments

                                                    For example: Neonatal program, child dental program or drug users recovery program.

                                                    Control0..*
                                                    BindingFor example codes, see ExampleProgramReasonCodes
                                                    (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                                    Program specific reason codes.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    1262. Claim.item:ZusatzpunkteIntensiv.serviced[x]
                                                    Definition

                                                    The date or dates when the service or product was supplied, performed or completed.

                                                    ShortDate or dates of service or product delivery
                                                    Control0..1
                                                    TypeChoice of: date, Period
                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    1264. Claim.item:ZusatzpunkteIntensiv.location[x]
                                                    Definition

                                                    Where the product or service was provided.

                                                    ShortPlace of service or where product was supplied
                                                    Control0..1
                                                    BindingFor example codes, see ExampleServicePlaceCodes
                                                    (example to http://hl7.org/fhir/ValueSet/service-place|5.0.0)

                                                    Place of service: pharmacy, school, prison, etc.

                                                    TypeChoice of: CodeableConcept, Address, Reference(Location)
                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    1266. Claim.item:ZusatzpunkteIntensiv.patientPaid
                                                    Definition

                                                    The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                                    ShortPaid by the patient
                                                    Control0..1
                                                    TypeMoney
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    1268. Claim.item:ZusatzpunkteIntensiv.quantity
                                                    Definition

                                                    The number of repetitions of a service or product.

                                                    ShortPunkteanzahl
                                                    Control1..1
                                                    TypeQuantity(SimpleQuantity)
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Required when the product or service code does not convey the quantity provided.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    1270. Claim.item:ZusatzpunkteIntensiv.quantity.id
                                                    Definition

                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    Typeid
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    1272. Claim.item:ZusatzpunkteIntensiv.quantity.extension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                    ShortAdditional content defined by implementations
                                                    Comments

                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 1274. Claim.item:ZusatzpunkteIntensiv.quantity.value
                                                      Definition

                                                      The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                      ShortNumerical value (with implicit precision)
                                                      Comments

                                                      The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                      Control1..1
                                                      Typedecimal
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      Precision is handled implicitly in almost all cases of measurement.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1276. Claim.item:ZusatzpunkteIntensiv.quantity.comparator
                                                      Definition

                                                      Not allowed to be used in this context

                                                      Short< | <= | >= | > | ad - how to understand the value
                                                      Control0..0
                                                      BindingThe codes SHALL be taken from QuantityComparator
                                                      (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                                      How the Quantity should be understood and represented.

                                                      Typecode
                                                      Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                      Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1278. Claim.item:ZusatzpunkteIntensiv.quantity.unit
                                                      Definition

                                                      A human-readable form of the unit.

                                                      ShortUnit representation
                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                      Pattern ValueLKF Punkte
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1280. Claim.item:ZusatzpunkteIntensiv.quantity.system
                                                      Definition

                                                      The identification of the system that provides the coded form of the unit.

                                                      ShortSystem that defines coded unit form
                                                      Control0..1
                                                      This element is affected by the following invariants: qty-3
                                                      Typeuri
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      Need to know the system that defines the coded form of the unit.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1282. Claim.item:ZusatzpunkteIntensiv.quantity.code
                                                      Definition

                                                      A computer processable form of the unit in some unit representation system.

                                                      ShortCoded form of the unit
                                                      Comments

                                                      The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                      Control0..1
                                                      This element is affected by the following invariants: qty-3
                                                      Typecode
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Requirements

                                                      Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1284. Claim.item:ZusatzpunkteIntensiv.unitPrice
                                                      Definition

                                                      If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                      ShortFee, charge or cost per item
                                                      Control0..1
                                                      TypeMoney
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      The amount charged to the patient by the provider for a single unit.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1286. Claim.item:ZusatzpunkteIntensiv.factor
                                                      Definition

                                                      A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                      ShortPrice scaling factor
                                                      Comments

                                                      To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                      Control0..1
                                                      Typedecimal
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1288. Claim.item:ZusatzpunkteIntensiv.tax
                                                      Definition

                                                      The total of taxes applicable for this product or service.

                                                      ShortTotal tax
                                                      Control0..1
                                                      TypeMoney
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Required when taxes are not embedded in the unit price or provided as a separate service.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1290. Claim.item:ZusatzpunkteIntensiv.net
                                                      Definition

                                                      The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                                      ShortTotal item cost
                                                      Comments

                                                      For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                      Control0..1
                                                      TypeMoney
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Provides the total amount claimed for the group (if a grouper) or the line item.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1292. Claim.item:ZusatzpunkteIntensiv.udi
                                                      Definition

                                                      Unique Device Identifiers associated with this line item.

                                                      ShortUnique device identifier
                                                      Control0..*
                                                      TypeReference(Device)
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      The UDI code allows the insurer to obtain device level information on the product supplied.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1294. Claim.item:ZusatzpunkteIntensiv.bodySite
                                                      Definition

                                                      Physical location where the service is performed or applies.

                                                      ShortAnatomical location
                                                      Control0..*
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1296. Claim.item:ZusatzpunkteIntensiv.bodySite.id
                                                      Definition

                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      1298. Claim.item:ZusatzpunkteIntensiv.bodySite.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      1300. Claim.item:ZusatzpunkteIntensiv.bodySite.modifierExtension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                      Summarytrue
                                                      Requirements

                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                      Alternate Namesextensions, user content, modifiers
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      1302. Claim.item:ZusatzpunkteIntensiv.bodySite.site
                                                      Definition

                                                      Physical service site on the patient (limb, tooth, etc.).

                                                      ShortLocation
                                                      Comments

                                                      For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                                      Control1..*
                                                      BindingFor example codes, see OralSiteCodes
                                                      (example to http://hl7.org/fhir/ValueSet/tooth|5.0.0)
                                                      TypeCodeableReference(BodyStructure)
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Allows insurer to validate specific procedures.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1304. Claim.item:ZusatzpunkteIntensiv.bodySite.subSite
                                                      Definition

                                                      A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                                      ShortSub-location
                                                      Control0..*
                                                      BindingFor example codes, see SurfaceCodes
                                                      (example to http://hl7.org/fhir/ValueSet/surface|5.0.0)
                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Allows insurer to validate specific procedures.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1306. Claim.item:ZusatzpunkteIntensiv.encounter
                                                      Definition

                                                      Healthcare encounters related to this claim.

                                                      ShortEncounters associated with the listed treatments
                                                      Comments

                                                      This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                                                      Control0..*
                                                      TypeReference(Encounter)
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Used in some jurisdictions to link clinical events to claim items.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1308. Claim.item:ZusatzpunkteIntensiv.detail
                                                      Definition

                                                      A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                      ShortProduct or service provided
                                                      Control0..*
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      The items to be processed for adjudication.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1310. Claim.item:ZusatzpunkteIntensiv.detail.id
                                                      Definition

                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      1312. Claim.item:ZusatzpunkteIntensiv.detail.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      1314. Claim.item:ZusatzpunkteIntensiv.detail.modifierExtension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                      Summarytrue
                                                      Requirements

                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                      Alternate Namesextensions, user content, modifiers
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      1316. Claim.item:ZusatzpunkteIntensiv.detail.sequence
                                                      Definition

                                                      A number to uniquely identify item entries.

                                                      ShortItem instance identifier
                                                      Control1..1
                                                      TypepositiveInt
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1318. Claim.item:ZusatzpunkteIntensiv.detail.traceNumber
                                                      Definition

                                                      Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                      ShortNumber for tracking
                                                      Control0..*
                                                      TypeIdentifier
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Allows partners to uniquely identify components for tracking.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1320. Claim.item:ZusatzpunkteIntensiv.detail.revenue
                                                      Definition

                                                      The type of revenue or cost center providing the product and/or service.

                                                      ShortRevenue or cost center code
                                                      Control0..1
                                                      BindingFor example codes, see ExampleRevenueCenterCodes
                                                      (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                                      Codes for the revenue or cost centers supplying the service and/or products.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Needed in the processing of institutional claims.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1322. Claim.item:ZusatzpunkteIntensiv.detail.category
                                                      Definition

                                                      Code to identify the general type of benefits under which products and services are provided.

                                                      ShortBenefit classification
                                                      Comments

                                                      Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                      Control0..1
                                                      BindingFor example codes, see BenefitCategoryCodes
                                                      (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                                      Benefit categories such as: oral-basic, major, glasses.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1324. Claim.item:ZusatzpunkteIntensiv.detail.productOrService
                                                      Definition

                                                      When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                                      ShortBilling, service, product, or drug code
                                                      Comments

                                                      If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                      Control0..1
                                                      BindingFor example codes, see USCLSCodes
                                                      (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                                      Allowable service and product codes.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Necessary to state what was provided or done.

                                                      Alternate NamesDrug Code, Bill Code, Service Code
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1326. Claim.item:ZusatzpunkteIntensiv.detail.productOrServiceEnd
                                                      Definition

                                                      This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                                      ShortEnd of a range of codes
                                                      Control0..1
                                                      BindingFor example codes, see USCLSCodes
                                                      (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1328. Claim.item:ZusatzpunkteIntensiv.detail.modifier
                                                      Definition

                                                      Item typification or modifiers codes to convey additional context for the product or service.

                                                      ShortService/Product billing modifiers
                                                      Comments

                                                      For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                                      Control0..*
                                                      BindingFor example codes, see ModifierTypeCodes
                                                      (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                                      Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      To support inclusion of the item for adjudication or to charge an elevated fee.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1330. Claim.item:ZusatzpunkteIntensiv.detail.programCode
                                                      Definition

                                                      Identifies the program under which this may be recovered.

                                                      ShortProgram the product or service is provided under
                                                      Comments

                                                      For example: Neonatal program, child dental program or drug users recovery program.

                                                      Control0..*
                                                      BindingFor example codes, see ExampleProgramReasonCodes
                                                      (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                                      Program specific reason codes.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1332. Claim.item:ZusatzpunkteIntensiv.detail.patientPaid
                                                      Definition

                                                      The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                                      ShortPaid by the patient
                                                      Control0..1
                                                      TypeMoney
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1334. Claim.item:ZusatzpunkteIntensiv.detail.quantity
                                                      Definition

                                                      The number of repetitions of a service or product.

                                                      ShortCount of products or services
                                                      Control0..1
                                                      TypeQuantity(SimpleQuantity)
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Required when the product or service code does not convey the quantity provided.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1336. Claim.item:ZusatzpunkteIntensiv.detail.unitPrice
                                                      Definition

                                                      If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                      ShortFee, charge or cost per item
                                                      Control0..1
                                                      TypeMoney
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      The amount charged to the patient by the provider for a single unit.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1338. Claim.item:ZusatzpunkteIntensiv.detail.factor
                                                      Definition

                                                      A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                      ShortPrice scaling factor
                                                      Comments

                                                      To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                      Control0..1
                                                      Typedecimal
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1340. Claim.item:ZusatzpunkteIntensiv.detail.tax
                                                      Definition

                                                      The total of taxes applicable for this product or service.

                                                      ShortTotal tax
                                                      Control0..1
                                                      TypeMoney
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Required when taxes are not embedded in the unit price or provided as a separate service.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1342. Claim.item:ZusatzpunkteIntensiv.detail.net
                                                      Definition

                                                      The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                                      ShortTotal item cost
                                                      Comments

                                                      For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                      Control0..1
                                                      TypeMoney
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Provides the total amount claimed for the group (if a grouper) or the line item.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1344. Claim.item:ZusatzpunkteIntensiv.detail.udi
                                                      Definition

                                                      Unique Device Identifiers associated with this line item.

                                                      ShortUnique device identifier
                                                      Control0..*
                                                      TypeReference(Device)
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      The UDI code allows the insurer to obtain device level information on the product supplied.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1346. Claim.item:ZusatzpunkteIntensiv.detail.subDetail
                                                      Definition

                                                      A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                      ShortProduct or service provided
                                                      Control0..*
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      The items to be processed for adjudication.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1348. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.id
                                                      Definition

                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      1350. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      1352. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.modifierExtension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                      Summarytrue
                                                      Requirements

                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                      Alternate Namesextensions, user content, modifiers
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      1354. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.sequence
                                                      Definition

                                                      A number to uniquely identify item entries.

                                                      ShortItem instance identifier
                                                      Control1..1
                                                      TypepositiveInt
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1356. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.traceNumber
                                                      Definition

                                                      Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                      ShortNumber for tracking
                                                      Control0..*
                                                      TypeIdentifier
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Allows partners to uniquely identify components for tracking.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1358. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.revenue
                                                      Definition

                                                      The type of revenue or cost center providing the product and/or service.

                                                      ShortRevenue or cost center code
                                                      Control0..1
                                                      BindingFor example codes, see ExampleRevenueCenterCodes
                                                      (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                                      Codes for the revenue or cost centers supplying the service and/or products.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Needed in the processing of institutional claims.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1360. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.category
                                                      Definition

                                                      Code to identify the general type of benefits under which products and services are provided.

                                                      ShortBenefit classification
                                                      Comments

                                                      Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                      Control0..1
                                                      BindingFor example codes, see BenefitCategoryCodes
                                                      (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                                      Benefit categories such as: oral-basic, major, glasses.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1362. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.productOrService
                                                      Definition

                                                      When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                                      ShortBilling, service, product, or drug code
                                                      Comments

                                                      If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                      Control0..1
                                                      BindingFor example codes, see USCLSCodes
                                                      (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                                      Allowable service and product codes.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Necessary to state what was provided or done.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1364. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.productOrServiceEnd
                                                      Definition

                                                      This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                                      ShortEnd of a range of codes
                                                      Control0..1
                                                      BindingFor example codes, see USCLSCodes
                                                      (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1366. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.modifier
                                                      Definition

                                                      Item typification or modifiers codes to convey additional context for the product or service.

                                                      ShortService/Product billing modifiers
                                                      Comments

                                                      For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                                      Control0..*
                                                      BindingFor example codes, see ModifierTypeCodes
                                                      (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                                      Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      To support inclusion of the item for adjudication or to charge an elevated fee.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1368. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.programCode
                                                      Definition

                                                      Identifies the program under which this may be recovered.

                                                      ShortProgram the product or service is provided under
                                                      Comments

                                                      For example: Neonatal program, child dental program or drug users recovery program.

                                                      Control0..*
                                                      BindingFor example codes, see ExampleProgramReasonCodes
                                                      (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                                      Program specific reason codes.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1370. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.patientPaid
                                                      Definition

                                                      The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                                      ShortPaid by the patient
                                                      Control0..1
                                                      TypeMoney
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1372. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.quantity
                                                      Definition

                                                      The number of repetitions of a service or product.

                                                      ShortCount of products or services
                                                      Control0..1
                                                      TypeQuantity(SimpleQuantity)
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Required when the product or service code does not convey the quantity provided.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1374. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.unitPrice
                                                      Definition

                                                      If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                      ShortFee, charge or cost per item
                                                      Control0..1
                                                      TypeMoney
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      The amount charged to the patient by the provider for a single unit.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1376. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.factor
                                                      Definition

                                                      A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                      ShortPrice scaling factor
                                                      Comments

                                                      To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                      Control0..1
                                                      Typedecimal
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1378. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.tax
                                                      Definition

                                                      The total of taxes applicable for this product or service.

                                                      ShortTotal tax
                                                      Control0..1
                                                      TypeMoney
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Required when taxes are not embedded in the unit price or provided as a separate service.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1380. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.net
                                                      Definition

                                                      The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                                      ShortTotal item cost
                                                      Comments

                                                      For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                      Control0..1
                                                      TypeMoney
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Provides the total amount claimed for the group (if a grouper) or the line item.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1382. Claim.item:ZusatzpunkteIntensiv.detail.subDetail.udi
                                                      Definition

                                                      Unique Device Identifiers associated with this line item.

                                                      ShortUnique device identifier
                                                      Control0..*
                                                      TypeReference(Device)
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      The UDI code allows the insurer to obtain device level information on the product supplied.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1384. Claim.item:ZusatzpunkteMehrfachleistungen
                                                      Slice NameZusatzpunkteMehrfachleistungen
                                                      Definition

                                                      A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

                                                      ShortProduct or service provided
                                                      Control0..1
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      The items to be processed for adjudication.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1386. Claim.item:ZusatzpunkteMehrfachleistungen.id
                                                      Definition

                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      1388. Claim.item:ZusatzpunkteMehrfachleistungen.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      1390. Claim.item:ZusatzpunkteMehrfachleistungen.modifierExtension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                      Summarytrue
                                                      Requirements

                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                      Alternate Namesextensions, user content, modifiers
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      1392. Claim.item:ZusatzpunkteMehrfachleistungen.sequence
                                                      Definition

                                                      A number to uniquely identify item entries.

                                                      ShortItem instance identifier
                                                      Control1..1
                                                      TypepositiveInt
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1394. Claim.item:ZusatzpunkteMehrfachleistungen.traceNumber
                                                      Definition

                                                      Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                      ShortNumber for tracking
                                                      Control0..*
                                                      TypeIdentifier
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Allows partners to uniquely identify components for tracking.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1396. Claim.item:ZusatzpunkteMehrfachleistungen.careTeamSequence
                                                      Definition

                                                      CareTeam members related to this service or product.

                                                      ShortApplicable careTeam members
                                                      Control0..*
                                                      TypepositiveInt
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Need to identify the individuals and their roles in the provision of the product or service.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1398. Claim.item:ZusatzpunkteMehrfachleistungen.diagnosisSequence
                                                      Definition

                                                      Diagnosis applicable for this service or product.

                                                      ShortApplicable diagnoses
                                                      Control0..*
                                                      TypepositiveInt
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Need to related the product or service to the associated diagnoses.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1400. Claim.item:ZusatzpunkteMehrfachleistungen.procedureSequence
                                                      Definition

                                                      Procedures applicable for this service or product.

                                                      ShortApplicable procedures
                                                      Control0..*
                                                      TypepositiveInt
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Need to provide any listed specific procedures to support the product or service being claimed.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1402. Claim.item:ZusatzpunkteMehrfachleistungen.informationSequence
                                                      Definition

                                                      Exceptions, special conditions and supporting information applicable for this service or product.

                                                      ShortApplicable exception and supporting information
                                                      Control0..*
                                                      TypepositiveInt
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Need to reference the supporting information items that relate directly to this product or service.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1404. Claim.item:ZusatzpunkteMehrfachleistungen.revenue
                                                      Definition

                                                      The type of revenue or cost center providing the product and/or service.

                                                      ShortRevenue or cost center code
                                                      Control0..1
                                                      BindingFor example codes, see ExampleRevenueCenterCodes
                                                      (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                                      Codes for the revenue or cost centers supplying the service and/or products.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Needed in the processing of institutional claims.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1406. Claim.item:ZusatzpunkteMehrfachleistungen.category
                                                      Definition

                                                      Code to identify the general type of benefits under which products and services are provided.

                                                      ShortBenefit classification
                                                      Comments

                                                      Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                      Control0..1
                                                      BindingFor example codes, see BenefitCategoryCodes
                                                      (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                                      Benefit categories such as: oral-basic, major, glasses.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      1408. Claim.item:ZusatzpunkteMehrfachleistungen.category.id
                                                      Definition

                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typeid
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      1410. Claim.item:ZusatzpunkteMehrfachleistungen.category.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 1412. Claim.item:ZusatzpunkteMehrfachleistungen.category.coding
                                                        Definition

                                                        A reference to a code defined by a terminology system.

                                                        ShortCode defined by a terminology system
                                                        Comments

                                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                        Control1..*
                                                        BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                                        (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                                        TypeCoding
                                                        Is Modifierfalse
                                                        Summarytrue
                                                        Requirements

                                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                                        Pattern Value{
                                                          "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                                          "code" : "MELZU"
                                                        }
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1414. Claim.item:ZusatzpunkteMehrfachleistungen.category.text
                                                        Definition

                                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                        ShortPlain text representation of the concept
                                                        Comments

                                                        Very often the text is the same as a displayName of one of the codings.

                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Requirements

                                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1416. Claim.item:ZusatzpunkteMehrfachleistungen.productOrService
                                                        Definition

                                                        When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                                        ShortBilling, service, product, or drug code
                                                        Comments

                                                        If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                        Control0..1
                                                        BindingFor example codes, see USCLSCodes
                                                        (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                                        Allowable service and product codes.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Necessary to state what was provided or done.

                                                        Alternate NamesDrug Code, Bill Code, Service Code
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1418. Claim.item:ZusatzpunkteMehrfachleistungen.productOrServiceEnd
                                                        Definition

                                                        This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                                        ShortEnd of a range of codes
                                                        Control0..1
                                                        BindingFor example codes, see USCLSCodes
                                                        (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1420. Claim.item:ZusatzpunkteMehrfachleistungen.request
                                                        Definition

                                                        Request or Referral for Goods or Service to be rendered.

                                                        ShortRequest or Referral for Service
                                                        Control0..*
                                                        TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        May identify the service to be provided or provider authorization for the service.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1422. Claim.item:ZusatzpunkteMehrfachleistungen.modifier
                                                        Definition

                                                        Item typification or modifiers codes to convey additional context for the product or service.

                                                        ShortProduct or service billing modifiers
                                                        Comments

                                                        For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.

                                                        Control0..*
                                                        BindingFor example codes, see ModifierTypeCodes
                                                        (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                                        Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        To support inclusion of the item for adjudication or to charge an elevated fee.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1424. Claim.item:ZusatzpunkteMehrfachleistungen.programCode
                                                        Definition

                                                        Identifies the program under which this may be recovered.

                                                        ShortProgram the product or service is provided under
                                                        Comments

                                                        For example: Neonatal program, child dental program or drug users recovery program.

                                                        Control0..*
                                                        BindingFor example codes, see ExampleProgramReasonCodes
                                                        (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                                        Program specific reason codes.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1426. Claim.item:ZusatzpunkteMehrfachleistungen.serviced[x]
                                                        Definition

                                                        The date or dates when the service or product was supplied, performed or completed.

                                                        ShortDate or dates of service or product delivery
                                                        Control0..1
                                                        TypeChoice of: date, Period
                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1428. Claim.item:ZusatzpunkteMehrfachleistungen.location[x]
                                                        Definition

                                                        Where the product or service was provided.

                                                        ShortPlace of service or where product was supplied
                                                        Control0..1
                                                        BindingFor example codes, see ExampleServicePlaceCodes
                                                        (example to http://hl7.org/fhir/ValueSet/service-place|5.0.0)

                                                        Place of service: pharmacy, school, prison, etc.

                                                        TypeChoice of: CodeableConcept, Address, Reference(Location)
                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1430. Claim.item:ZusatzpunkteMehrfachleistungen.patientPaid
                                                        Definition

                                                        The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                                        ShortPaid by the patient
                                                        Control0..1
                                                        TypeMoney
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1432. Claim.item:ZusatzpunkteMehrfachleistungen.quantity
                                                        Definition

                                                        The number of repetitions of a service or product.

                                                        ShortPunkteanzahl
                                                        Control1..1
                                                        TypeQuantity(SimpleQuantity)
                                                        Is Modifierfalse
                                                        Must Supportfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Required when the product or service code does not convey the quantity provided.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        1434. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.id
                                                        Definition

                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                        ShortUnique id for inter-element referencing
                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        Typeid
                                                        Is Modifierfalse
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        Summaryfalse
                                                        1436. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.extension
                                                        Definition

                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                        ShortAdditional content defined by implementations
                                                        Comments

                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 1438. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.value
                                                          Definition

                                                          The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                          ShortNumerical value (with implicit precision)
                                                          Comments

                                                          The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                          Control1..1
                                                          Typedecimal
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Requirements

                                                          Precision is handled implicitly in almost all cases of measurement.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1440. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.comparator
                                                          Definition

                                                          Not allowed to be used in this context

                                                          Short< | <= | >= | > | ad - how to understand the value
                                                          Control0..0
                                                          BindingThe codes SHALL be taken from QuantityComparator
                                                          (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                                          How the Quantity should be understood and represented.

                                                          Typecode
                                                          Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Requirements

                                                          Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                          Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1442. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.unit
                                                          Definition

                                                          A human-readable form of the unit.

                                                          ShortUnit representation
                                                          Control0..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Requirements

                                                          There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                          Pattern ValueLKF Punkte
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1444. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.system
                                                          Definition

                                                          The identification of the system that provides the coded form of the unit.

                                                          ShortSystem that defines coded unit form
                                                          Control0..1
                                                          This element is affected by the following invariants: qty-3
                                                          Typeuri
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Requirements

                                                          Need to know the system that defines the coded form of the unit.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1446. Claim.item:ZusatzpunkteMehrfachleistungen.quantity.code
                                                          Definition

                                                          A computer processable form of the unit in some unit representation system.

                                                          ShortCoded form of the unit
                                                          Comments

                                                          The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                          Control0..1
                                                          This element is affected by the following invariants: qty-3
                                                          Typecode
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summarytrue
                                                          Requirements

                                                          Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1448. Claim.item:ZusatzpunkteMehrfachleistungen.unitPrice
                                                          Definition

                                                          If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                          ShortFee, charge or cost per item
                                                          Control0..1
                                                          TypeMoney
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          The amount charged to the patient by the provider for a single unit.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1450. Claim.item:ZusatzpunkteMehrfachleistungen.factor
                                                          Definition

                                                          A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                          ShortPrice scaling factor
                                                          Comments

                                                          To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                          Control0..1
                                                          Typedecimal
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1452. Claim.item:ZusatzpunkteMehrfachleistungen.tax
                                                          Definition

                                                          The total of taxes applicable for this product or service.

                                                          ShortTotal tax
                                                          Control0..1
                                                          TypeMoney
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Required when taxes are not embedded in the unit price or provided as a separate service.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1454. Claim.item:ZusatzpunkteMehrfachleistungen.net
                                                          Definition

                                                          The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                                          ShortTotal item cost
                                                          Comments

                                                          For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                          Control0..1
                                                          TypeMoney
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Provides the total amount claimed for the group (if a grouper) or the line item.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1456. Claim.item:ZusatzpunkteMehrfachleistungen.udi
                                                          Definition

                                                          Unique Device Identifiers associated with this line item.

                                                          ShortUnique device identifier
                                                          Control0..*
                                                          TypeReference(Device)
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          The UDI code allows the insurer to obtain device level information on the product supplied.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1458. Claim.item:ZusatzpunkteMehrfachleistungen.bodySite
                                                          Definition

                                                          Physical location where the service is performed or applies.

                                                          ShortAnatomical location
                                                          Control0..*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1460. Claim.item:ZusatzpunkteMehrfachleistungen.bodySite.id
                                                          Definition

                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          Typestring
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          1462. Claim.item:ZusatzpunkteMehrfachleistungen.bodySite.extension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                          ShortAdditional content defined by implementations
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Alternate Namesextensions, user content
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          1464. Claim.item:ZusatzpunkteMehrfachleistungen.bodySite.modifierExtension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                          Summarytrue
                                                          Requirements

                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                          Alternate Namesextensions, user content, modifiers
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          1466. Claim.item:ZusatzpunkteMehrfachleistungen.bodySite.site
                                                          Definition

                                                          Physical service site on the patient (limb, tooth, etc.).

                                                          ShortLocation
                                                          Comments

                                                          For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                                          Control1..*
                                                          BindingFor example codes, see OralSiteCodes
                                                          (example to http://hl7.org/fhir/ValueSet/tooth|5.0.0)
                                                          TypeCodeableReference(BodyStructure)
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Allows insurer to validate specific procedures.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1468. Claim.item:ZusatzpunkteMehrfachleistungen.bodySite.subSite
                                                          Definition

                                                          A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                                          ShortSub-location
                                                          Control0..*
                                                          BindingFor example codes, see SurfaceCodes
                                                          (example to http://hl7.org/fhir/ValueSet/surface|5.0.0)
                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Allows insurer to validate specific procedures.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1470. Claim.item:ZusatzpunkteMehrfachleistungen.encounter
                                                          Definition

                                                          Healthcare encounters related to this claim.

                                                          ShortEncounters associated with the listed treatments
                                                          Comments

                                                          This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                                                          Control0..*
                                                          TypeReference(Encounter)
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Used in some jurisdictions to link clinical events to claim items.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1472. Claim.item:ZusatzpunkteMehrfachleistungen.detail
                                                          Definition

                                                          A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                          ShortProduct or service provided
                                                          Control0..*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          The items to be processed for adjudication.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1474. Claim.item:ZusatzpunkteMehrfachleistungen.detail.id
                                                          Definition

                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          Typestring
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          1476. Claim.item:ZusatzpunkteMehrfachleistungen.detail.extension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                          ShortAdditional content defined by implementations
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Alternate Namesextensions, user content
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          1478. Claim.item:ZusatzpunkteMehrfachleistungen.detail.modifierExtension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                          Summarytrue
                                                          Requirements

                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                          Alternate Namesextensions, user content, modifiers
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          1480. Claim.item:ZusatzpunkteMehrfachleistungen.detail.sequence
                                                          Definition

                                                          A number to uniquely identify item entries.

                                                          ShortItem instance identifier
                                                          Control1..1
                                                          TypepositiveInt
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1482. Claim.item:ZusatzpunkteMehrfachleistungen.detail.traceNumber
                                                          Definition

                                                          Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                          ShortNumber for tracking
                                                          Control0..*
                                                          TypeIdentifier
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Allows partners to uniquely identify components for tracking.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1484. Claim.item:ZusatzpunkteMehrfachleistungen.detail.revenue
                                                          Definition

                                                          The type of revenue or cost center providing the product and/or service.

                                                          ShortRevenue or cost center code
                                                          Control0..1
                                                          BindingFor example codes, see ExampleRevenueCenterCodes
                                                          (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                                          Codes for the revenue or cost centers supplying the service and/or products.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Needed in the processing of institutional claims.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1486. Claim.item:ZusatzpunkteMehrfachleistungen.detail.category
                                                          Definition

                                                          Code to identify the general type of benefits under which products and services are provided.

                                                          ShortBenefit classification
                                                          Comments

                                                          Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                          Control0..1
                                                          BindingFor example codes, see BenefitCategoryCodes
                                                          (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                                          Benefit categories such as: oral-basic, major, glasses.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1488. Claim.item:ZusatzpunkteMehrfachleistungen.detail.productOrService
                                                          Definition

                                                          When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                                          ShortBilling, service, product, or drug code
                                                          Comments

                                                          If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                          Control0..1
                                                          BindingFor example codes, see USCLSCodes
                                                          (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                                          Allowable service and product codes.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Necessary to state what was provided or done.

                                                          Alternate NamesDrug Code, Bill Code, Service Code
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1490. Claim.item:ZusatzpunkteMehrfachleistungen.detail.productOrServiceEnd
                                                          Definition

                                                          This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                                          ShortEnd of a range of codes
                                                          Control0..1
                                                          BindingFor example codes, see USCLSCodes
                                                          (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1492. Claim.item:ZusatzpunkteMehrfachleistungen.detail.modifier
                                                          Definition

                                                          Item typification or modifiers codes to convey additional context for the product or service.

                                                          ShortService/Product billing modifiers
                                                          Comments

                                                          For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                                          Control0..*
                                                          BindingFor example codes, see ModifierTypeCodes
                                                          (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                                          Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          To support inclusion of the item for adjudication or to charge an elevated fee.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1494. Claim.item:ZusatzpunkteMehrfachleistungen.detail.programCode
                                                          Definition

                                                          Identifies the program under which this may be recovered.

                                                          ShortProgram the product or service is provided under
                                                          Comments

                                                          For example: Neonatal program, child dental program or drug users recovery program.

                                                          Control0..*
                                                          BindingFor example codes, see ExampleProgramReasonCodes
                                                          (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                                          Program specific reason codes.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1496. Claim.item:ZusatzpunkteMehrfachleistungen.detail.patientPaid
                                                          Definition

                                                          The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                                          ShortPaid by the patient
                                                          Control0..1
                                                          TypeMoney
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1498. Claim.item:ZusatzpunkteMehrfachleistungen.detail.quantity
                                                          Definition

                                                          The number of repetitions of a service or product.

                                                          ShortCount of products or services
                                                          Control0..1
                                                          TypeQuantity(SimpleQuantity)
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Required when the product or service code does not convey the quantity provided.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1500. Claim.item:ZusatzpunkteMehrfachleistungen.detail.unitPrice
                                                          Definition

                                                          If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                          ShortFee, charge or cost per item
                                                          Control0..1
                                                          TypeMoney
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          The amount charged to the patient by the provider for a single unit.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1502. Claim.item:ZusatzpunkteMehrfachleistungen.detail.factor
                                                          Definition

                                                          A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                          ShortPrice scaling factor
                                                          Comments

                                                          To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                          Control0..1
                                                          Typedecimal
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1504. Claim.item:ZusatzpunkteMehrfachleistungen.detail.tax
                                                          Definition

                                                          The total of taxes applicable for this product or service.

                                                          ShortTotal tax
                                                          Control0..1
                                                          TypeMoney
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Required when taxes are not embedded in the unit price or provided as a separate service.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1506. Claim.item:ZusatzpunkteMehrfachleistungen.detail.net
                                                          Definition

                                                          The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                                          ShortTotal item cost
                                                          Comments

                                                          For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                          Control0..1
                                                          TypeMoney
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Provides the total amount claimed for the group (if a grouper) or the line item.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1508. Claim.item:ZusatzpunkteMehrfachleistungen.detail.udi
                                                          Definition

                                                          Unique Device Identifiers associated with this line item.

                                                          ShortUnique device identifier
                                                          Control0..*
                                                          TypeReference(Device)
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          The UDI code allows the insurer to obtain device level information on the product supplied.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1510. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail
                                                          Definition

                                                          A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                          ShortProduct or service provided
                                                          Control0..*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          The items to be processed for adjudication.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1512. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.id
                                                          Definition

                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          Typestring
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          1514. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.extension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                          ShortAdditional content defined by implementations
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Alternate Namesextensions, user content
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          1516. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.modifierExtension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                          Summarytrue
                                                          Requirements

                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                          Alternate Namesextensions, user content, modifiers
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          1518. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.sequence
                                                          Definition

                                                          A number to uniquely identify item entries.

                                                          ShortItem instance identifier
                                                          Control1..1
                                                          TypepositiveInt
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1520. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.traceNumber
                                                          Definition

                                                          Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                          ShortNumber for tracking
                                                          Control0..*
                                                          TypeIdentifier
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Allows partners to uniquely identify components for tracking.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1522. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.revenue
                                                          Definition

                                                          The type of revenue or cost center providing the product and/or service.

                                                          ShortRevenue or cost center code
                                                          Control0..1
                                                          BindingFor example codes, see ExampleRevenueCenterCodes
                                                          (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                                          Codes for the revenue or cost centers supplying the service and/or products.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Needed in the processing of institutional claims.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1524. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.category
                                                          Definition

                                                          Code to identify the general type of benefits under which products and services are provided.

                                                          ShortBenefit classification
                                                          Comments

                                                          Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                          Control0..1
                                                          BindingFor example codes, see BenefitCategoryCodes
                                                          (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                                          Benefit categories such as: oral-basic, major, glasses.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1526. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.productOrService
                                                          Definition

                                                          When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                                          ShortBilling, service, product, or drug code
                                                          Comments

                                                          If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                          Control0..1
                                                          BindingFor example codes, see USCLSCodes
                                                          (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                                          Allowable service and product codes.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Necessary to state what was provided or done.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1528. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.productOrServiceEnd
                                                          Definition

                                                          This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                                          ShortEnd of a range of codes
                                                          Control0..1
                                                          BindingFor example codes, see USCLSCodes
                                                          (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1530. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.modifier
                                                          Definition

                                                          Item typification or modifiers codes to convey additional context for the product or service.

                                                          ShortService/Product billing modifiers
                                                          Comments

                                                          For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                                          Control0..*
                                                          BindingFor example codes, see ModifierTypeCodes
                                                          (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                                          Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          To support inclusion of the item for adjudication or to charge an elevated fee.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1532. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.programCode
                                                          Definition

                                                          Identifies the program under which this may be recovered.

                                                          ShortProgram the product or service is provided under
                                                          Comments

                                                          For example: Neonatal program, child dental program or drug users recovery program.

                                                          Control0..*
                                                          BindingFor example codes, see ExampleProgramReasonCodes
                                                          (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                                          Program specific reason codes.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1534. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.patientPaid
                                                          Definition

                                                          The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                                          ShortPaid by the patient
                                                          Control0..1
                                                          TypeMoney
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1536. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.quantity
                                                          Definition

                                                          The number of repetitions of a service or product.

                                                          ShortCount of products or services
                                                          Control0..1
                                                          TypeQuantity(SimpleQuantity)
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Required when the product or service code does not convey the quantity provided.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1538. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.unitPrice
                                                          Definition

                                                          If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                          ShortFee, charge or cost per item
                                                          Control0..1
                                                          TypeMoney
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          The amount charged to the patient by the provider for a single unit.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1540. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.factor
                                                          Definition

                                                          A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                          ShortPrice scaling factor
                                                          Comments

                                                          To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                          Control0..1
                                                          Typedecimal
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1542. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.tax
                                                          Definition

                                                          The total of taxes applicable for this product or service.

                                                          ShortTotal tax
                                                          Control0..1
                                                          TypeMoney
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Required when taxes are not embedded in the unit price or provided as a separate service.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1544. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.net
                                                          Definition

                                                          The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                                          ShortTotal item cost
                                                          Comments

                                                          For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                          Control0..1
                                                          TypeMoney
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Provides the total amount claimed for the group (if a grouper) or the line item.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1546. Claim.item:ZusatzpunkteMehrfachleistungen.detail.subDetail.udi
                                                          Definition

                                                          Unique Device Identifiers associated with this line item.

                                                          ShortUnique device identifier
                                                          Control0..*
                                                          TypeReference(Device)
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          The UDI code allows the insurer to obtain device level information on the product supplied.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1548. Claim.item:PunkteSpeziellerBereicheTageweise
                                                          Slice NamePunkteSpeziellerBereicheTageweise
                                                          Definition

                                                          A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

                                                          ShortProduct or service provided
                                                          Control0..1
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          The items to be processed for adjudication.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1550. Claim.item:PunkteSpeziellerBereicheTageweise.id
                                                          Definition

                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          Typestring
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          1552. Claim.item:PunkteSpeziellerBereicheTageweise.extension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                          ShortAdditional content defined by implementations
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Alternate Namesextensions, user content
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          1554. Claim.item:PunkteSpeziellerBereicheTageweise.modifierExtension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                          Summarytrue
                                                          Requirements

                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                          Alternate Namesextensions, user content, modifiers
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          1556. Claim.item:PunkteSpeziellerBereicheTageweise.sequence
                                                          Definition

                                                          A number to uniquely identify item entries.

                                                          ShortItem instance identifier
                                                          Control1..1
                                                          TypepositiveInt
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1558. Claim.item:PunkteSpeziellerBereicheTageweise.traceNumber
                                                          Definition

                                                          Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                          ShortNumber for tracking
                                                          Control0..*
                                                          TypeIdentifier
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Allows partners to uniquely identify components for tracking.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1560. Claim.item:PunkteSpeziellerBereicheTageweise.careTeamSequence
                                                          Definition

                                                          CareTeam members related to this service or product.

                                                          ShortApplicable careTeam members
                                                          Control0..*
                                                          TypepositiveInt
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Need to identify the individuals and their roles in the provision of the product or service.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1562. Claim.item:PunkteSpeziellerBereicheTageweise.diagnosisSequence
                                                          Definition

                                                          Diagnosis applicable for this service or product.

                                                          ShortApplicable diagnoses
                                                          Control0..*
                                                          TypepositiveInt
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Need to related the product or service to the associated diagnoses.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1564. Claim.item:PunkteSpeziellerBereicheTageweise.procedureSequence
                                                          Definition

                                                          Procedures applicable for this service or product.

                                                          ShortApplicable procedures
                                                          Control0..*
                                                          TypepositiveInt
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Need to provide any listed specific procedures to support the product or service being claimed.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1566. Claim.item:PunkteSpeziellerBereicheTageweise.informationSequence
                                                          Definition

                                                          Exceptions, special conditions and supporting information applicable for this service or product.

                                                          ShortApplicable exception and supporting information
                                                          Control0..*
                                                          TypepositiveInt
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Need to reference the supporting information items that relate directly to this product or service.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1568. Claim.item:PunkteSpeziellerBereicheTageweise.revenue
                                                          Definition

                                                          The type of revenue or cost center providing the product and/or service.

                                                          ShortRevenue or cost center code
                                                          Control0..1
                                                          BindingFor example codes, see ExampleRevenueCenterCodes
                                                          (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                                          Codes for the revenue or cost centers supplying the service and/or products.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Needed in the processing of institutional claims.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1570. Claim.item:PunkteSpeziellerBereicheTageweise.category
                                                          Definition

                                                          Code to identify the general type of benefits under which products and services are provided.

                                                          ShortBenefit classification
                                                          Comments

                                                          Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                          Control0..1
                                                          BindingFor example codes, see BenefitCategoryCodes
                                                          (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                                          Benefit categories such as: oral-basic, major, glasses.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supportfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          1572. Claim.item:PunkteSpeziellerBereicheTageweise.category.id
                                                          Definition

                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                          ShortUnique id for inter-element referencing
                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          Typeid
                                                          Is Modifierfalse
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          Summaryfalse
                                                          1574. Claim.item:PunkteSpeziellerBereicheTageweise.category.extension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                          ShortAdditional content defined by implementations
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Alternate Namesextensions, user content
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 1576. Claim.item:PunkteSpeziellerBereicheTageweise.category.coding
                                                            Definition

                                                            A reference to a code defined by a terminology system.

                                                            ShortCode defined by a terminology system
                                                            Comments

                                                            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                            Control1..*
                                                            BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                                            (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                                            TypeCoding
                                                            Is Modifierfalse
                                                            Summarytrue
                                                            Requirements

                                                            Allows for alternative encodings within a code system, and translations to other code systems.

                                                            Pattern Value{
                                                              "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                                              "code" : "SCSPEZ"
                                                            }
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1578. Claim.item:PunkteSpeziellerBereicheTageweise.category.text
                                                            Definition

                                                            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                            ShortPlain text representation of the concept
                                                            Comments

                                                            Very often the text is the same as a displayName of one of the codings.

                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summarytrue
                                                            Requirements

                                                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1580. Claim.item:PunkteSpeziellerBereicheTageweise.productOrService
                                                            Definition

                                                            When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                                            ShortBilling, service, product, or drug code
                                                            Comments

                                                            If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                            Control0..1
                                                            BindingFor example codes, see USCLSCodes
                                                            (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                                            Allowable service and product codes.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Necessary to state what was provided or done.

                                                            Alternate NamesDrug Code, Bill Code, Service Code
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1582. Claim.item:PunkteSpeziellerBereicheTageweise.productOrServiceEnd
                                                            Definition

                                                            This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                                            ShortEnd of a range of codes
                                                            Control0..1
                                                            BindingFor example codes, see USCLSCodes
                                                            (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1584. Claim.item:PunkteSpeziellerBereicheTageweise.request
                                                            Definition

                                                            Request or Referral for Goods or Service to be rendered.

                                                            ShortRequest or Referral for Service
                                                            Control0..*
                                                            TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            May identify the service to be provided or provider authorization for the service.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1586. Claim.item:PunkteSpeziellerBereicheTageweise.modifier
                                                            Definition

                                                            Item typification or modifiers codes to convey additional context for the product or service.

                                                            ShortProduct or service billing modifiers
                                                            Comments

                                                            For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.

                                                            Control0..*
                                                            BindingFor example codes, see ModifierTypeCodes
                                                            (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                                            Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            To support inclusion of the item for adjudication or to charge an elevated fee.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1588. Claim.item:PunkteSpeziellerBereicheTageweise.programCode
                                                            Definition

                                                            Identifies the program under which this may be recovered.

                                                            ShortProgram the product or service is provided under
                                                            Comments

                                                            For example: Neonatal program, child dental program or drug users recovery program.

                                                            Control0..*
                                                            BindingFor example codes, see ExampleProgramReasonCodes
                                                            (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                                            Program specific reason codes.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1590. Claim.item:PunkteSpeziellerBereicheTageweise.serviced[x]
                                                            Definition

                                                            The date or dates when the service or product was supplied, performed or completed.

                                                            ShortDate or dates of service or product delivery
                                                            Control0..1
                                                            TypeChoice of: date, Period
                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1592. Claim.item:PunkteSpeziellerBereicheTageweise.location[x]
                                                            Definition

                                                            Where the product or service was provided.

                                                            ShortPlace of service or where product was supplied
                                                            Control0..1
                                                            BindingFor example codes, see ExampleServicePlaceCodes
                                                            (example to http://hl7.org/fhir/ValueSet/service-place|5.0.0)

                                                            Place of service: pharmacy, school, prison, etc.

                                                            TypeChoice of: CodeableConcept, Address, Reference(Location)
                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1594. Claim.item:PunkteSpeziellerBereicheTageweise.patientPaid
                                                            Definition

                                                            The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                                            ShortPaid by the patient
                                                            Control0..1
                                                            TypeMoney
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1596. Claim.item:PunkteSpeziellerBereicheTageweise.quantity
                                                            Definition

                                                            The number of repetitions of a service or product.

                                                            ShortPunkteanzahl
                                                            Control1..1
                                                            TypeQuantity(SimpleQuantity)
                                                            Is Modifierfalse
                                                            Must Supportfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Required when the product or service code does not convey the quantity provided.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            1598. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.id
                                                            Definition

                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            This element is affected by the following invariants: ele-1
                                                            Typeid
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            1600. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.extension
                                                            Definition

                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                            ShortAdditional content defined by implementations
                                                            Comments

                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Alternate Namesextensions, user content
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 1602. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.value
                                                              Definition

                                                              The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                              ShortNumerical value (with implicit precision)
                                                              Comments

                                                              The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                              Control1..1
                                                              Typedecimal
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Requirements

                                                              Precision is handled implicitly in almost all cases of measurement.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1604. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.comparator
                                                              Definition

                                                              Not allowed to be used in this context

                                                              Short< | <= | >= | > | ad - how to understand the value
                                                              Control0..0
                                                              BindingThe codes SHALL be taken from QuantityComparator
                                                              (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                                              How the Quantity should be understood and represented.

                                                              Typecode
                                                              Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Requirements

                                                              Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                              Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1606. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.unit
                                                              Definition

                                                              A human-readable form of the unit.

                                                              ShortUnit representation
                                                              Control0..1
                                                              Typestring
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Requirements

                                                              There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                              Pattern ValueLKF Punkte
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1608. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.system
                                                              Definition

                                                              The identification of the system that provides the coded form of the unit.

                                                              ShortSystem that defines coded unit form
                                                              Control0..1
                                                              This element is affected by the following invariants: qty-3
                                                              Typeuri
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Requirements

                                                              Need to know the system that defines the coded form of the unit.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1610. Claim.item:PunkteSpeziellerBereicheTageweise.quantity.code
                                                              Definition

                                                              A computer processable form of the unit in some unit representation system.

                                                              ShortCoded form of the unit
                                                              Comments

                                                              The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                              Control0..1
                                                              This element is affected by the following invariants: qty-3
                                                              Typecode
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Requirements

                                                              Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1612. Claim.item:PunkteSpeziellerBereicheTageweise.unitPrice
                                                              Definition

                                                              If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                              ShortFee, charge or cost per item
                                                              Control0..1
                                                              TypeMoney
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              The amount charged to the patient by the provider for a single unit.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1614. Claim.item:PunkteSpeziellerBereicheTageweise.factor
                                                              Definition

                                                              A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                              ShortPrice scaling factor
                                                              Comments

                                                              To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                              Control0..1
                                                              Typedecimal
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1616. Claim.item:PunkteSpeziellerBereicheTageweise.tax
                                                              Definition

                                                              The total of taxes applicable for this product or service.

                                                              ShortTotal tax
                                                              Control0..1
                                                              TypeMoney
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Required when taxes are not embedded in the unit price or provided as a separate service.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1618. Claim.item:PunkteSpeziellerBereicheTageweise.net
                                                              Definition

                                                              The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                                              ShortTotal item cost
                                                              Comments

                                                              For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                              Control0..1
                                                              TypeMoney
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Provides the total amount claimed for the group (if a grouper) or the line item.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1620. Claim.item:PunkteSpeziellerBereicheTageweise.udi
                                                              Definition

                                                              Unique Device Identifiers associated with this line item.

                                                              ShortUnique device identifier
                                                              Control0..*
                                                              TypeReference(Device)
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              The UDI code allows the insurer to obtain device level information on the product supplied.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1622. Claim.item:PunkteSpeziellerBereicheTageweise.bodySite
                                                              Definition

                                                              Physical location where the service is performed or applies.

                                                              ShortAnatomical location
                                                              Control0..*
                                                              TypeBackboneElement
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1624. Claim.item:PunkteSpeziellerBereicheTageweise.bodySite.id
                                                              Definition

                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              Typestring
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              1626. Claim.item:PunkteSpeziellerBereicheTageweise.bodySite.extension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                              ShortAdditional content defined by implementations
                                                              Comments

                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Alternate Namesextensions, user content
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              1628. Claim.item:PunkteSpeziellerBereicheTageweise.bodySite.modifierExtension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                              Comments

                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                              Summarytrue
                                                              Requirements

                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                              Alternate Namesextensions, user content, modifiers
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              1630. Claim.item:PunkteSpeziellerBereicheTageweise.bodySite.site
                                                              Definition

                                                              Physical service site on the patient (limb, tooth, etc.).

                                                              ShortLocation
                                                              Comments

                                                              For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                                              Control1..*
                                                              BindingFor example codes, see OralSiteCodes
                                                              (example to http://hl7.org/fhir/ValueSet/tooth|5.0.0)
                                                              TypeCodeableReference(BodyStructure)
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Allows insurer to validate specific procedures.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1632. Claim.item:PunkteSpeziellerBereicheTageweise.bodySite.subSite
                                                              Definition

                                                              A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                                              ShortSub-location
                                                              Control0..*
                                                              BindingFor example codes, see SurfaceCodes
                                                              (example to http://hl7.org/fhir/ValueSet/surface|5.0.0)
                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Allows insurer to validate specific procedures.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1634. Claim.item:PunkteSpeziellerBereicheTageweise.encounter
                                                              Definition

                                                              Healthcare encounters related to this claim.

                                                              ShortEncounters associated with the listed treatments
                                                              Comments

                                                              This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                                                              Control0..*
                                                              TypeReference(Encounter)
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Used in some jurisdictions to link clinical events to claim items.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1636. Claim.item:PunkteSpeziellerBereicheTageweise.detail
                                                              Definition

                                                              A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                              ShortProduct or service provided
                                                              Control0..*
                                                              TypeBackboneElement
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              The items to be processed for adjudication.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1638. Claim.item:PunkteSpeziellerBereicheTageweise.detail.id
                                                              Definition

                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              Typestring
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              1640. Claim.item:PunkteSpeziellerBereicheTageweise.detail.extension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                              ShortAdditional content defined by implementations
                                                              Comments

                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Alternate Namesextensions, user content
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              1642. Claim.item:PunkteSpeziellerBereicheTageweise.detail.modifierExtension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                              Comments

                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                              Summarytrue
                                                              Requirements

                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                              Alternate Namesextensions, user content, modifiers
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              1644. Claim.item:PunkteSpeziellerBereicheTageweise.detail.sequence
                                                              Definition

                                                              A number to uniquely identify item entries.

                                                              ShortItem instance identifier
                                                              Control1..1
                                                              TypepositiveInt
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1646. Claim.item:PunkteSpeziellerBereicheTageweise.detail.traceNumber
                                                              Definition

                                                              Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                              ShortNumber for tracking
                                                              Control0..*
                                                              TypeIdentifier
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Allows partners to uniquely identify components for tracking.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1648. Claim.item:PunkteSpeziellerBereicheTageweise.detail.revenue
                                                              Definition

                                                              The type of revenue or cost center providing the product and/or service.

                                                              ShortRevenue or cost center code
                                                              Control0..1
                                                              BindingFor example codes, see ExampleRevenueCenterCodes
                                                              (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                                              Codes for the revenue or cost centers supplying the service and/or products.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Needed in the processing of institutional claims.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1650. Claim.item:PunkteSpeziellerBereicheTageweise.detail.category
                                                              Definition

                                                              Code to identify the general type of benefits under which products and services are provided.

                                                              ShortBenefit classification
                                                              Comments

                                                              Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                              Control0..1
                                                              BindingFor example codes, see BenefitCategoryCodes
                                                              (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                                              Benefit categories such as: oral-basic, major, glasses.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1652. Claim.item:PunkteSpeziellerBereicheTageweise.detail.productOrService
                                                              Definition

                                                              When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                                              ShortBilling, service, product, or drug code
                                                              Comments

                                                              If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                              Control0..1
                                                              BindingFor example codes, see USCLSCodes
                                                              (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                                              Allowable service and product codes.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Necessary to state what was provided or done.

                                                              Alternate NamesDrug Code, Bill Code, Service Code
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1654. Claim.item:PunkteSpeziellerBereicheTageweise.detail.productOrServiceEnd
                                                              Definition

                                                              This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                                              ShortEnd of a range of codes
                                                              Control0..1
                                                              BindingFor example codes, see USCLSCodes
                                                              (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1656. Claim.item:PunkteSpeziellerBereicheTageweise.detail.modifier
                                                              Definition

                                                              Item typification or modifiers codes to convey additional context for the product or service.

                                                              ShortService/Product billing modifiers
                                                              Comments

                                                              For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                                              Control0..*
                                                              BindingFor example codes, see ModifierTypeCodes
                                                              (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                                              Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              To support inclusion of the item for adjudication or to charge an elevated fee.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1658. Claim.item:PunkteSpeziellerBereicheTageweise.detail.programCode
                                                              Definition

                                                              Identifies the program under which this may be recovered.

                                                              ShortProgram the product or service is provided under
                                                              Comments

                                                              For example: Neonatal program, child dental program or drug users recovery program.

                                                              Control0..*
                                                              BindingFor example codes, see ExampleProgramReasonCodes
                                                              (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                                              Program specific reason codes.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1660. Claim.item:PunkteSpeziellerBereicheTageweise.detail.patientPaid
                                                              Definition

                                                              The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                                              ShortPaid by the patient
                                                              Control0..1
                                                              TypeMoney
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1662. Claim.item:PunkteSpeziellerBereicheTageweise.detail.quantity
                                                              Definition

                                                              The number of repetitions of a service or product.

                                                              ShortCount of products or services
                                                              Control0..1
                                                              TypeQuantity(SimpleQuantity)
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Required when the product or service code does not convey the quantity provided.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1664. Claim.item:PunkteSpeziellerBereicheTageweise.detail.unitPrice
                                                              Definition

                                                              If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                              ShortFee, charge or cost per item
                                                              Control0..1
                                                              TypeMoney
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              The amount charged to the patient by the provider for a single unit.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1666. Claim.item:PunkteSpeziellerBereicheTageweise.detail.factor
                                                              Definition

                                                              A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                              ShortPrice scaling factor
                                                              Comments

                                                              To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                              Control0..1
                                                              Typedecimal
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1668. Claim.item:PunkteSpeziellerBereicheTageweise.detail.tax
                                                              Definition

                                                              The total of taxes applicable for this product or service.

                                                              ShortTotal tax
                                                              Control0..1
                                                              TypeMoney
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Required when taxes are not embedded in the unit price or provided as a separate service.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1670. Claim.item:PunkteSpeziellerBereicheTageweise.detail.net
                                                              Definition

                                                              The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                                              ShortTotal item cost
                                                              Comments

                                                              For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                              Control0..1
                                                              TypeMoney
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Provides the total amount claimed for the group (if a grouper) or the line item.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1672. Claim.item:PunkteSpeziellerBereicheTageweise.detail.udi
                                                              Definition

                                                              Unique Device Identifiers associated with this line item.

                                                              ShortUnique device identifier
                                                              Control0..*
                                                              TypeReference(Device)
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              The UDI code allows the insurer to obtain device level information on the product supplied.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1674. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail
                                                              Definition

                                                              A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                              ShortProduct or service provided
                                                              Control0..*
                                                              TypeBackboneElement
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              The items to be processed for adjudication.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1676. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.id
                                                              Definition

                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              Typestring
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              1678. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.extension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                              ShortAdditional content defined by implementations
                                                              Comments

                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Alternate Namesextensions, user content
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              1680. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.modifierExtension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                              Comments

                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                              Summarytrue
                                                              Requirements

                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                              Alternate Namesextensions, user content, modifiers
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              1682. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.sequence
                                                              Definition

                                                              A number to uniquely identify item entries.

                                                              ShortItem instance identifier
                                                              Control1..1
                                                              TypepositiveInt
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1684. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.traceNumber
                                                              Definition

                                                              Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                              ShortNumber for tracking
                                                              Control0..*
                                                              TypeIdentifier
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Allows partners to uniquely identify components for tracking.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1686. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.revenue
                                                              Definition

                                                              The type of revenue or cost center providing the product and/or service.

                                                              ShortRevenue or cost center code
                                                              Control0..1
                                                              BindingFor example codes, see ExampleRevenueCenterCodes
                                                              (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                                              Codes for the revenue or cost centers supplying the service and/or products.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Needed in the processing of institutional claims.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1688. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.category
                                                              Definition

                                                              Code to identify the general type of benefits under which products and services are provided.

                                                              ShortBenefit classification
                                                              Comments

                                                              Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                              Control0..1
                                                              BindingFor example codes, see BenefitCategoryCodes
                                                              (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                                              Benefit categories such as: oral-basic, major, glasses.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1690. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.productOrService
                                                              Definition

                                                              When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                                              ShortBilling, service, product, or drug code
                                                              Comments

                                                              If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                              Control0..1
                                                              BindingFor example codes, see USCLSCodes
                                                              (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                                              Allowable service and product codes.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Necessary to state what was provided or done.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1692. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.productOrServiceEnd
                                                              Definition

                                                              This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                                              ShortEnd of a range of codes
                                                              Control0..1
                                                              BindingFor example codes, see USCLSCodes
                                                              (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1694. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.modifier
                                                              Definition

                                                              Item typification or modifiers codes to convey additional context for the product or service.

                                                              ShortService/Product billing modifiers
                                                              Comments

                                                              For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                                              Control0..*
                                                              BindingFor example codes, see ModifierTypeCodes
                                                              (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                                              Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              To support inclusion of the item for adjudication or to charge an elevated fee.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1696. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.programCode
                                                              Definition

                                                              Identifies the program under which this may be recovered.

                                                              ShortProgram the product or service is provided under
                                                              Comments

                                                              For example: Neonatal program, child dental program or drug users recovery program.

                                                              Control0..*
                                                              BindingFor example codes, see ExampleProgramReasonCodes
                                                              (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                                              Program specific reason codes.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1698. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.patientPaid
                                                              Definition

                                                              The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                                              ShortPaid by the patient
                                                              Control0..1
                                                              TypeMoney
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1700. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.quantity
                                                              Definition

                                                              The number of repetitions of a service or product.

                                                              ShortCount of products or services
                                                              Control0..1
                                                              TypeQuantity(SimpleQuantity)
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Required when the product or service code does not convey the quantity provided.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1702. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.unitPrice
                                                              Definition

                                                              If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                              ShortFee, charge or cost per item
                                                              Control0..1
                                                              TypeMoney
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              The amount charged to the patient by the provider for a single unit.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1704. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.factor
                                                              Definition

                                                              A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                              ShortPrice scaling factor
                                                              Comments

                                                              To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                              Control0..1
                                                              Typedecimal
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1706. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.tax
                                                              Definition

                                                              The total of taxes applicable for this product or service.

                                                              ShortTotal tax
                                                              Control0..1
                                                              TypeMoney
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Required when taxes are not embedded in the unit price or provided as a separate service.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1708. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.net
                                                              Definition

                                                              The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                                              ShortTotal item cost
                                                              Comments

                                                              For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                              Control0..1
                                                              TypeMoney
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Provides the total amount claimed for the group (if a grouper) or the line item.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1710. Claim.item:PunkteSpeziellerBereicheTageweise.detail.subDetail.udi
                                                              Definition

                                                              Unique Device Identifiers associated with this line item.

                                                              ShortUnique device identifier
                                                              Control0..*
                                                              TypeReference(Device)
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              The UDI code allows the insurer to obtain device level information on the product supplied.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1712. Claim.item:Gesamtpunkte
                                                              Slice NameGesamtpunkte
                                                              Definition

                                                              A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

                                                              ShortProduct or service provided
                                                              Control1..1
                                                              TypeBackboneElement
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              The items to be processed for adjudication.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1714. Claim.item:Gesamtpunkte.id
                                                              Definition

                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              Typestring
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              1716. Claim.item:Gesamtpunkte.extension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                              ShortAdditional content defined by implementations
                                                              Comments

                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Alternate Namesextensions, user content
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              1718. Claim.item:Gesamtpunkte.modifierExtension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                              Comments

                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                              Summarytrue
                                                              Requirements

                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                              Alternate Namesextensions, user content, modifiers
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              1720. Claim.item:Gesamtpunkte.sequence
                                                              Definition

                                                              A number to uniquely identify item entries.

                                                              ShortItem instance identifier
                                                              Control1..1
                                                              TypepositiveInt
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1722. Claim.item:Gesamtpunkte.traceNumber
                                                              Definition

                                                              Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                              ShortNumber for tracking
                                                              Control0..*
                                                              TypeIdentifier
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Allows partners to uniquely identify components for tracking.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1724. Claim.item:Gesamtpunkte.careTeamSequence
                                                              Definition

                                                              CareTeam members related to this service or product.

                                                              ShortApplicable careTeam members
                                                              Control0..*
                                                              TypepositiveInt
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Need to identify the individuals and their roles in the provision of the product or service.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1726. Claim.item:Gesamtpunkte.diagnosisSequence
                                                              Definition

                                                              Diagnosis applicable for this service or product.

                                                              ShortApplicable diagnoses
                                                              Control0..*
                                                              TypepositiveInt
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Need to related the product or service to the associated diagnoses.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1728. Claim.item:Gesamtpunkte.procedureSequence
                                                              Definition

                                                              Procedures applicable for this service or product.

                                                              ShortApplicable procedures
                                                              Control0..*
                                                              TypepositiveInt
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Need to provide any listed specific procedures to support the product or service being claimed.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1730. Claim.item:Gesamtpunkte.informationSequence
                                                              Definition

                                                              Exceptions, special conditions and supporting information applicable for this service or product.

                                                              ShortApplicable exception and supporting information
                                                              Control0..*
                                                              TypepositiveInt
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Need to reference the supporting information items that relate directly to this product or service.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1732. Claim.item:Gesamtpunkte.revenue
                                                              Definition

                                                              The type of revenue or cost center providing the product and/or service.

                                                              ShortRevenue or cost center code
                                                              Control0..1
                                                              BindingFor example codes, see ExampleRevenueCenterCodes
                                                              (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                                              Codes for the revenue or cost centers supplying the service and/or products.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Needed in the processing of institutional claims.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1734. Claim.item:Gesamtpunkte.category
                                                              Definition

                                                              Code to identify the general type of benefits under which products and services are provided.

                                                              ShortBenefit classification
                                                              Comments

                                                              Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                              Control0..1
                                                              BindingFor example codes, see BenefitCategoryCodes
                                                              (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                                              Benefit categories such as: oral-basic, major, glasses.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supportfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              1736. Claim.item:Gesamtpunkte.category.id
                                                              Definition

                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              Typeid
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              1738. Claim.item:Gesamtpunkte.category.extension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                              ShortAdditional content defined by implementations
                                                              Comments

                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Alternate Namesextensions, user content
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              SlicingThis element introduces a set of slices on Claim.item.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 1740. Claim.item:Gesamtpunkte.category.coding
                                                                Definition

                                                                A reference to a code defined by a terminology system.

                                                                ShortCode defined by a terminology system
                                                                Comments

                                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                Control1..*
                                                                BindingThe codes SHALL be taken from Moped Claim Item Category ValueSet
                                                                (required to https://elga.moped.at/ValueSet/MopedClaimItemCategoryVS)
                                                                TypeCoding
                                                                Is Modifierfalse
                                                                Summarytrue
                                                                Requirements

                                                                Allows for alternative encodings within a code system, and translations to other code systems.

                                                                Pattern Value{
                                                                  "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS",
                                                                  "code" : "SCGES"
                                                                }
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1742. Claim.item:Gesamtpunkte.category.text
                                                                Definition

                                                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                ShortPlain text representation of the concept
                                                                Comments

                                                                Very often the text is the same as a displayName of one of the codings.

                                                                Control0..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summarytrue
                                                                Requirements

                                                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1744. Claim.item:Gesamtpunkte.productOrService
                                                                Definition

                                                                When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                                                ShortBilling, service, product, or drug code
                                                                Comments

                                                                If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                                Control0..1
                                                                BindingFor example codes, see USCLSCodes
                                                                (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                                                Allowable service and product codes.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Necessary to state what was provided or done.

                                                                Alternate NamesDrug Code, Bill Code, Service Code
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1746. Claim.item:Gesamtpunkte.productOrServiceEnd
                                                                Definition

                                                                This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                                                ShortEnd of a range of codes
                                                                Control0..1
                                                                BindingFor example codes, see USCLSCodes
                                                                (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1748. Claim.item:Gesamtpunkte.request
                                                                Definition

                                                                Request or Referral for Goods or Service to be rendered.

                                                                ShortRequest or Referral for Service
                                                                Control0..*
                                                                TypeReference(DeviceRequest, MedicationRequest, NutritionOrder, ServiceRequest, SupplyRequest, VisionPrescription)
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                May identify the service to be provided or provider authorization for the service.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1750. Claim.item:Gesamtpunkte.modifier
                                                                Definition

                                                                Item typification or modifiers codes to convey additional context for the product or service.

                                                                ShortProduct or service billing modifiers
                                                                Comments

                                                                For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.

                                                                Control0..*
                                                                BindingFor example codes, see ModifierTypeCodes
                                                                (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                                                Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1752. Claim.item:Gesamtpunkte.programCode
                                                                Definition

                                                                Identifies the program under which this may be recovered.

                                                                ShortProgram the product or service is provided under
                                                                Comments

                                                                For example: Neonatal program, child dental program or drug users recovery program.

                                                                Control0..*
                                                                BindingFor example codes, see ExampleProgramReasonCodes
                                                                (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                                                Program specific reason codes.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1754. Claim.item:Gesamtpunkte.serviced[x]
                                                                Definition

                                                                The date or dates when the service or product was supplied, performed or completed.

                                                                ShortDate or dates of service or product delivery
                                                                Control0..1
                                                                TypeChoice of: date, Period
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Needed to determine whether the service or product was provided during the term of the insurance coverage.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1756. Claim.item:Gesamtpunkte.location[x]
                                                                Definition

                                                                Where the product or service was provided.

                                                                ShortPlace of service or where product was supplied
                                                                Control0..1
                                                                BindingFor example codes, see ExampleServicePlaceCodes
                                                                (example to http://hl7.org/fhir/ValueSet/service-place|5.0.0)

                                                                Place of service: pharmacy, school, prison, etc.

                                                                TypeChoice of: CodeableConcept, Address, Reference(Location)
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1758. Claim.item:Gesamtpunkte.patientPaid
                                                                Definition

                                                                The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                                                ShortPaid by the patient
                                                                Control0..1
                                                                TypeMoney
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1760. Claim.item:Gesamtpunkte.quantity
                                                                Definition

                                                                The number of repetitions of a service or product.

                                                                ShortPunkteanzahl
                                                                Control1..1
                                                                TypeQuantity(SimpleQuantity)
                                                                Is Modifierfalse
                                                                Must Supportfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Required when the product or service code does not convey the quantity provided.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                1762. Claim.item:Gesamtpunkte.quantity.id
                                                                Definition

                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                Typeid
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                1764. Claim.item:Gesamtpunkte.quantity.extension
                                                                Definition

                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                ShortAdditional content defined by implementations
                                                                Comments

                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Alternate Namesextensions, user content
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                SlicingThis element introduces a set of slices on Claim.item.quantity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 1766. Claim.item:Gesamtpunkte.quantity.value
                                                                  Definition

                                                                  The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                  ShortNumerical value (with implicit precision)
                                                                  Comments

                                                                  The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                                  Control1..1
                                                                  Typedecimal
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Requirements

                                                                  Precision is handled implicitly in almost all cases of measurement.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1768. Claim.item:Gesamtpunkte.quantity.comparator
                                                                  Definition

                                                                  Not allowed to be used in this context

                                                                  Short< | <= | >= | > | ad - how to understand the value
                                                                  Control0..0
                                                                  BindingThe codes SHALL be taken from QuantityComparator
                                                                  (required to http://hl7.org/fhir/ValueSet/quantity-comparator|5.0.0)

                                                                  How the Quantity should be understood and represented.

                                                                  Typecode
                                                                  Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Requirements

                                                                  Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                  Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1770. Claim.item:Gesamtpunkte.quantity.unit
                                                                  Definition

                                                                  A human-readable form of the unit.

                                                                  ShortUnit representation
                                                                  Control0..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Requirements

                                                                  There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                  Pattern ValueLKF Punkte
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1772. Claim.item:Gesamtpunkte.quantity.system
                                                                  Definition

                                                                  The identification of the system that provides the coded form of the unit.

                                                                  ShortSystem that defines coded unit form
                                                                  Control0..1
                                                                  This element is affected by the following invariants: qty-3
                                                                  Typeuri
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Requirements

                                                                  Need to know the system that defines the coded form of the unit.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1774. Claim.item:Gesamtpunkte.quantity.code
                                                                  Definition

                                                                  A computer processable form of the unit in some unit representation system.

                                                                  ShortCoded form of the unit
                                                                  Comments

                                                                  The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                                  Control0..1
                                                                  This element is affected by the following invariants: qty-3
                                                                  Typecode
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summarytrue
                                                                  Requirements

                                                                  Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1776. Claim.item:Gesamtpunkte.unitPrice
                                                                  Definition

                                                                  If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                                  ShortFee, charge or cost per item
                                                                  Control0..1
                                                                  TypeMoney
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  The amount charged to the patient by the provider for a single unit.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1778. Claim.item:Gesamtpunkte.factor
                                                                  Definition

                                                                  A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                                  ShortPrice scaling factor
                                                                  Comments

                                                                  To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                  Control0..1
                                                                  Typedecimal
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1780. Claim.item:Gesamtpunkte.tax
                                                                  Definition

                                                                  The total of taxes applicable for this product or service.

                                                                  ShortTotal tax
                                                                  Control0..1
                                                                  TypeMoney
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Required when taxes are not embedded in the unit price or provided as a separate service.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1782. Claim.item:Gesamtpunkte.net
                                                                  Definition

                                                                  The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

                                                                  ShortTotal item cost
                                                                  Comments

                                                                  For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                  Control0..1
                                                                  TypeMoney
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1784. Claim.item:Gesamtpunkte.udi
                                                                  Definition

                                                                  Unique Device Identifiers associated with this line item.

                                                                  ShortUnique device identifier
                                                                  Control0..*
                                                                  TypeReference(Device)
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1786. Claim.item:Gesamtpunkte.bodySite
                                                                  Definition

                                                                  Physical location where the service is performed or applies.

                                                                  ShortAnatomical location
                                                                  Control0..*
                                                                  TypeBackboneElement
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1788. Claim.item:Gesamtpunkte.bodySite.id
                                                                  Definition

                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  1790. Claim.item:Gesamtpunkte.bodySite.extension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                  ShortAdditional content defined by implementations
                                                                  Comments

                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Alternate Namesextensions, user content
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  1792. Claim.item:Gesamtpunkte.bodySite.modifierExtension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                  Comments

                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                  Summarytrue
                                                                  Requirements

                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                  Alternate Namesextensions, user content, modifiers
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  1794. Claim.item:Gesamtpunkte.bodySite.site
                                                                  Definition

                                                                  Physical service site on the patient (limb, tooth, etc.).

                                                                  ShortLocation
                                                                  Comments

                                                                  For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

                                                                  Control1..*
                                                                  BindingFor example codes, see OralSiteCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/tooth|5.0.0)
                                                                  TypeCodeableReference(BodyStructure)
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Allows insurer to validate specific procedures.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1796. Claim.item:Gesamtpunkte.bodySite.subSite
                                                                  Definition

                                                                  A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                                                  ShortSub-location
                                                                  Control0..*
                                                                  BindingFor example codes, see SurfaceCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/surface|5.0.0)
                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Allows insurer to validate specific procedures.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1798. Claim.item:Gesamtpunkte.encounter
                                                                  Definition

                                                                  Healthcare encounters related to this claim.

                                                                  ShortEncounters associated with the listed treatments
                                                                  Comments

                                                                  This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

                                                                  Control0..*
                                                                  TypeReference(Encounter)
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Used in some jurisdictions to link clinical events to claim items.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1800. Claim.item:Gesamtpunkte.detail
                                                                  Definition

                                                                  A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                                  ShortProduct or service provided
                                                                  Control0..*
                                                                  TypeBackboneElement
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  The items to be processed for adjudication.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1802. Claim.item:Gesamtpunkte.detail.id
                                                                  Definition

                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  1804. Claim.item:Gesamtpunkte.detail.extension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                  ShortAdditional content defined by implementations
                                                                  Comments

                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Alternate Namesextensions, user content
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  1806. Claim.item:Gesamtpunkte.detail.modifierExtension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                  Comments

                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                  Summarytrue
                                                                  Requirements

                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                  Alternate Namesextensions, user content, modifiers
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  1808. Claim.item:Gesamtpunkte.detail.sequence
                                                                  Definition

                                                                  A number to uniquely identify item entries.

                                                                  ShortItem instance identifier
                                                                  Control1..1
                                                                  TypepositiveInt
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1810. Claim.item:Gesamtpunkte.detail.traceNumber
                                                                  Definition

                                                                  Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                                  ShortNumber for tracking
                                                                  Control0..*
                                                                  TypeIdentifier
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Allows partners to uniquely identify components for tracking.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1812. Claim.item:Gesamtpunkte.detail.revenue
                                                                  Definition

                                                                  The type of revenue or cost center providing the product and/or service.

                                                                  ShortRevenue or cost center code
                                                                  Control0..1
                                                                  BindingFor example codes, see ExampleRevenueCenterCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                                                  Codes for the revenue or cost centers supplying the service and/or products.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Needed in the processing of institutional claims.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1814. Claim.item:Gesamtpunkte.detail.category
                                                                  Definition

                                                                  Code to identify the general type of benefits under which products and services are provided.

                                                                  ShortBenefit classification
                                                                  Comments

                                                                  Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                  Control0..1
                                                                  BindingFor example codes, see BenefitCategoryCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                                                  Benefit categories such as: oral-basic, major, glasses.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1816. Claim.item:Gesamtpunkte.detail.productOrService
                                                                  Definition

                                                                  When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                                                  ShortBilling, service, product, or drug code
                                                                  Comments

                                                                  If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                                  Control0..1
                                                                  BindingFor example codes, see USCLSCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                                                  Allowable service and product codes.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Necessary to state what was provided or done.

                                                                  Alternate NamesDrug Code, Bill Code, Service Code
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1818. Claim.item:Gesamtpunkte.detail.productOrServiceEnd
                                                                  Definition

                                                                  This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                                                  ShortEnd of a range of codes
                                                                  Control0..1
                                                                  BindingFor example codes, see USCLSCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1820. Claim.item:Gesamtpunkte.detail.modifier
                                                                  Definition

                                                                  Item typification or modifiers codes to convey additional context for the product or service.

                                                                  ShortService/Product billing modifiers
                                                                  Comments

                                                                  For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                                                  Control0..*
                                                                  BindingFor example codes, see ModifierTypeCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                                                  Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1822. Claim.item:Gesamtpunkte.detail.programCode
                                                                  Definition

                                                                  Identifies the program under which this may be recovered.

                                                                  ShortProgram the product or service is provided under
                                                                  Comments

                                                                  For example: Neonatal program, child dental program or drug users recovery program.

                                                                  Control0..*
                                                                  BindingFor example codes, see ExampleProgramReasonCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                                                  Program specific reason codes.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1824. Claim.item:Gesamtpunkte.detail.patientPaid
                                                                  Definition

                                                                  The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                                                  ShortPaid by the patient
                                                                  Control0..1
                                                                  TypeMoney
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1826. Claim.item:Gesamtpunkte.detail.quantity
                                                                  Definition

                                                                  The number of repetitions of a service or product.

                                                                  ShortCount of products or services
                                                                  Control0..1
                                                                  TypeQuantity(SimpleQuantity)
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Required when the product or service code does not convey the quantity provided.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1828. Claim.item:Gesamtpunkte.detail.unitPrice
                                                                  Definition

                                                                  If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                                  ShortFee, charge or cost per item
                                                                  Control0..1
                                                                  TypeMoney
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  The amount charged to the patient by the provider for a single unit.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1830. Claim.item:Gesamtpunkte.detail.factor
                                                                  Definition

                                                                  A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                                  ShortPrice scaling factor
                                                                  Comments

                                                                  To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                  Control0..1
                                                                  Typedecimal
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1832. Claim.item:Gesamtpunkte.detail.tax
                                                                  Definition

                                                                  The total of taxes applicable for this product or service.

                                                                  ShortTotal tax
                                                                  Control0..1
                                                                  TypeMoney
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Required when taxes are not embedded in the unit price or provided as a separate service.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1834. Claim.item:Gesamtpunkte.detail.net
                                                                  Definition

                                                                  The total amount claimed for the group (if a grouper) or the line item.detail. Net = unit price * quantity * factor.

                                                                  ShortTotal item cost
                                                                  Comments

                                                                  For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                  Control0..1
                                                                  TypeMoney
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1836. Claim.item:Gesamtpunkte.detail.udi
                                                                  Definition

                                                                  Unique Device Identifiers associated with this line item.

                                                                  ShortUnique device identifier
                                                                  Control0..*
                                                                  TypeReference(Device)
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1838. Claim.item:Gesamtpunkte.detail.subDetail
                                                                  Definition

                                                                  A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

                                                                  ShortProduct or service provided
                                                                  Control0..*
                                                                  TypeBackboneElement
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  The items to be processed for adjudication.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1840. Claim.item:Gesamtpunkte.detail.subDetail.id
                                                                  Definition

                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Summaryfalse
                                                                  1842. Claim.item:Gesamtpunkte.detail.subDetail.extension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                  ShortAdditional content defined by implementations
                                                                  Comments

                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Alternate Namesextensions, user content
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  1844. Claim.item:Gesamtpunkte.detail.subDetail.modifierExtension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                  Comments

                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                  Summarytrue
                                                                  Requirements

                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                  Alternate Namesextensions, user content, modifiers
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  1846. Claim.item:Gesamtpunkte.detail.subDetail.sequence
                                                                  Definition

                                                                  A number to uniquely identify item entries.

                                                                  ShortItem instance identifier
                                                                  Control1..1
                                                                  TypepositiveInt
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1848. Claim.item:Gesamtpunkte.detail.subDetail.traceNumber
                                                                  Definition

                                                                  Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

                                                                  ShortNumber for tracking
                                                                  Control0..*
                                                                  TypeIdentifier
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Allows partners to uniquely identify components for tracking.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1850. Claim.item:Gesamtpunkte.detail.subDetail.revenue
                                                                  Definition

                                                                  The type of revenue or cost center providing the product and/or service.

                                                                  ShortRevenue or cost center code
                                                                  Control0..1
                                                                  BindingFor example codes, see ExampleRevenueCenterCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/ex-revenue-center|5.0.0)

                                                                  Codes for the revenue or cost centers supplying the service and/or products.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Needed in the processing of institutional claims.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1852. Claim.item:Gesamtpunkte.detail.subDetail.category
                                                                  Definition

                                                                  Code to identify the general type of benefits under which products and services are provided.

                                                                  ShortBenefit classification
                                                                  Comments

                                                                  Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

                                                                  Control0..1
                                                                  BindingFor example codes, see BenefitCategoryCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/ex-benefitcategory|5.0.0)

                                                                  Benefit categories such as: oral-basic, major, glasses.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1854. Claim.item:Gesamtpunkte.detail.subDetail.productOrService
                                                                  Definition

                                                                  When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

                                                                  ShortBilling, service, product, or drug code
                                                                  Comments

                                                                  If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                                  Control0..1
                                                                  BindingFor example codes, see USCLSCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)

                                                                  Allowable service and product codes.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Necessary to state what was provided or done.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1856. Claim.item:Gesamtpunkte.detail.subDetail.productOrServiceEnd
                                                                  Definition

                                                                  This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

                                                                  ShortEnd of a range of codes
                                                                  Control0..1
                                                                  BindingFor example codes, see USCLSCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/service-uscls|5.0.0)
                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Alternate NamesEnd of a range of Drug Code; Bill Code; Service Cod
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1858. Claim.item:Gesamtpunkte.detail.subDetail.modifier
                                                                  Definition

                                                                  Item typification or modifiers codes to convey additional context for the product or service.

                                                                  ShortService/Product billing modifiers
                                                                  Comments

                                                                  For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

                                                                  Control0..*
                                                                  BindingFor example codes, see ModifierTypeCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/claim-modifiers|5.0.0)

                                                                  Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  To support inclusion of the item for adjudication or to charge an elevated fee.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1860. Claim.item:Gesamtpunkte.detail.subDetail.programCode
                                                                  Definition

                                                                  Identifies the program under which this may be recovered.

                                                                  ShortProgram the product or service is provided under
                                                                  Comments

                                                                  For example: Neonatal program, child dental program or drug users recovery program.

                                                                  Control0..*
                                                                  BindingFor example codes, see ExampleProgramReasonCodes
                                                                  (example to http://hl7.org/fhir/ValueSet/ex-program-code|5.0.0)

                                                                  Program specific reason codes.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1862. Claim.item:Gesamtpunkte.detail.subDetail.patientPaid
                                                                  Definition

                                                                  The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

                                                                  ShortPaid by the patient
                                                                  Control0..1
                                                                  TypeMoney
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Necessary to demonstrate that copayments, co-insurance and similar patient payments have been made or accounted for.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1864. Claim.item:Gesamtpunkte.detail.subDetail.quantity
                                                                  Definition

                                                                  The number of repetitions of a service or product.

                                                                  ShortCount of products or services
                                                                  Control0..1
                                                                  TypeQuantity(SimpleQuantity)
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Required when the product or service code does not convey the quantity provided.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1866. Claim.item:Gesamtpunkte.detail.subDetail.unitPrice
                                                                  Definition

                                                                  If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                                  ShortFee, charge or cost per item
                                                                  Control0..1
                                                                  TypeMoney
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  The amount charged to the patient by the provider for a single unit.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1868. Claim.item:Gesamtpunkte.detail.subDetail.factor
                                                                  Definition

                                                                  A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                                  ShortPrice scaling factor
                                                                  Comments

                                                                  To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

                                                                  Control0..1
                                                                  Typedecimal
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1870. Claim.item:Gesamtpunkte.detail.subDetail.tax
                                                                  Definition

                                                                  The total of taxes applicable for this product or service.

                                                                  ShortTotal tax
                                                                  Control0..1
                                                                  TypeMoney
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Required when taxes are not embedded in the unit price or provided as a separate service.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1872. Claim.item:Gesamtpunkte.detail.subDetail.net
                                                                  Definition

                                                                  The total amount claimed for line item.detail.subDetail. Net = unit price * quantity * factor.

                                                                  ShortTotal item cost
                                                                  Comments

                                                                  For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                  Control0..1
                                                                  TypeMoney
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Provides the total amount claimed for the group (if a grouper) or the line item.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1874. Claim.item:Gesamtpunkte.detail.subDetail.udi
                                                                  Definition

                                                                  Unique Device Identifiers associated with this line item.

                                                                  ShortUnique device identifier
                                                                  Control0..*
                                                                  TypeReference(Device)
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  The UDI code allows the insurer to obtain device level information on the product supplied.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  1876. Claim.total
                                                                  Definition

                                                                  The total value of the all the items in the claim.

                                                                  ShortTotal claim cost
                                                                  Control0..1
                                                                  TypeMoney
                                                                  Is Modifierfalse
                                                                  Must Supportfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Used for control total purposes.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))