Patient Cost Transparency Implementation Guide
2.0.0-draft - STU 2 - Draft United States of America flag

Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.0-draft built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

Resource Profile: PCT Good Faith Estimate Professional

Official URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional Version: 2.0.0-draft
Standards status: Trial-use Maturity Level: 2 Computable Name: PCTGFEProfessional
Other Identifiers: OID:2.16.840.1.113883.4.642.40.4.42.14

PCT Good Faith Estimate Professional is a profile for capturing submission data needed to be processed by a payer for the creation of an Advanced EOB. This profile is used for a professional GFE submission.

Notes on Fields

  • The estimated service date, when available at the header level, is placed in Claim.billablePeriod. If the estimated date of service is available at the line level it is placed in Claim.item.serviced[x].

Examples of .providerEventMethodology usage examples below:

Example 1 – A provider is offering both a surgical and a drug therapy-based option to the patient. The provider can add text such as "Surgical care option" and "Drug therapy option" to the GFE so that the patient could easily understand the options without having to understand different CPT codes.
    Example 2 – A provider added services to a previously submitted GFE. They would be able to add "Added physical therapist on Sep 18, ignore estimates submitted on Sep 17".

Usage:

Changes since version 1.1.0:

  • The data elements list has changed
  • One or more text definitions, invariants or bindings have changed
  • Formal Views of Profile Content

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

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Claim 0..* Claim Claim, Pre-determination or Pre-authorization
    dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    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
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    dom-6: A resource should have narrative for robust management
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ele-1: All FHIR elements must have a @value or children
    ... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... gfeServiceLinkingInfo S 0..1 (Complex) GFE Service Linking Information
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... providerEventMethodology S 0..1 string Provider event collection methodology
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerEventMethodology
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... gfeDisclaimer S 0..* string Disclaimers the patient should be made aware of regarding the providers estimate
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeDisclaimer
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... Slices for identifier 1..* Identifier Business Identifier for claim
    Slice: Unordered, Open by value:type
    ele-1: All FHIR elements must have a @value or children
    .... identifier:PLAC 1..1 Identifier Provider Assigned Identifier for GFE Claim
    ele-1: All FHIR elements must have a @value or children
    ..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
    Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


    ele-1: All FHIR elements must have a @value or children
    ..... type Σ 1..1 CodeableConcept Description of identifier
    Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: PLAC
    ....... display 1..1 string Representation defined by the system
    Fixed Value: Placer Identifier
    ..... system SΣ 0..1 uri The namespace for the identifier value
    ele-1: All FHIR elements must have a @value or children
    Example General: http://www.acme.com/identifiers/patient
    ..... value Σ 1..1 string The value that is unique
    ele-1: All FHIR elements must have a @value or children
    Example General: 123456
    .... identifier:INTER 0..* Identifier Intermediary System Identifier
    ele-1: All FHIR elements must have a @value or children
    ..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
    Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


    ele-1: All FHIR elements must have a @value or children
    ..... type Σ 1..1 CodeableConcept Description of identifier
    Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTIdentifierType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: INTER
    ....... display 1..1 string Representation defined by the system
    Fixed Value: Intermediary System Identifier
    ... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
    Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.


    ele-1: All FHIR elements must have a @value or children
    ... type Σ 1..1 CodeableConcept Category or discipline
    Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.


    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: professional
    ... use Σ 1..1 code claim | preauthorization | predetermination
    Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.


    ele-1: All FHIR elements must have a @value or children
    Required Pattern: predetermination
    ... patient Σ 1..1 Reference(HRex Patient Demographics) The recipient of the products and services
    ele-1: All FHIR elements must have a @value or children
    ... created Σ 1..1 dateTime Resource creation date
    ele-1: All FHIR elements must have a @value or children
    ... insurer SΣ 0..1 Reference(PCT Organization) Required if insured estimate
    ele-1: All FHIR elements must have a @value or children
    ... provider Σ 1..1 Reference(PCT Organization | PCT Practitioner) Billing provider - party responsible for the GFE
    ele-1: All FHIR elements must have a @value or children
    .... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... providerTaxonomy 1..1 CodeableConcept Provider taxonomy codes consisting of NUCC Health Care Provider Taxonomy Code Set for providers
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerTaxonomy
    Binding: US Core Provider Role (NUCC) (extensible)
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... consentForBalanceBilling S 0..1 boolean Extension
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeConsentForBalanceBilling
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... priority Σ 1..1 CodeableConcept Desired processing ugency
    Binding: ProcessPriorityCodes (required)
    ele-1: All FHIR elements must have a @value or children
    ... payee S 0..1 BackboneElement Recipient of benefits payable
    ele-1: All FHIR elements must have a @value or children
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... type 1..1 CodeableConcept Category of recipient
    Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.


    ele-1: All FHIR elements must have a @value or children
    .... party 0..1 Reference(PCT Practitioner | PCT Organization) Recipient reference
    ele-1: All FHIR elements must have a @value or children
    ... Slices for careTeam S 0..* BackboneElement Members of the care team
    Slice: Unordered, Open by value:role
    ele-1: All FHIR elements must have a @value or children
    .... careTeam:All Slices Content/Rules for all slices
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Order of care team
    ele-1: All FHIR elements must have a @value or children
    ..... provider 1..1 Reference(PCT Practitioner | PCT Organization) Practitioner or organization
    ele-1: All FHIR elements must have a @value or children
    ..... role 1..1 CodeableConcept Function within the team
    Binding: PCT Care Team Role Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    ..... qualification 0..1 CodeableConcept Practitioner credential or specialization
    Binding: US Core Provider Role (NUCC) (required)
    ele-1: All FHIR elements must have a @value or children
    .... careTeam:rendering 0..* BackboneElement Members of the care team
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Order of care team
    ele-1: All FHIR elements must have a @value or children
    ..... provider 1..1 Reference(PCT Practitioner | PCT Organization) Practitioner or organization
    ele-1: All FHIR elements must have a @value or children
    ..... role 1..1 CodeableConcept Function within the team
    Binding: PCT Care Team Role Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTCareTeamRole
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: rendering
    ..... qualification 1..1 CodeableConcept Practitioner credential or specialization - must provide a taxonomy code for the Professional case
    Binding: US Core Provider Role (NUCC) (required)
    ele-1: All FHIR elements must have a @value or children
    .... careTeam:referring 0..1 BackboneElement Members of the care team
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Order of care team
    ele-1: All FHIR elements must have a @value or children
    ..... provider 1..1 Reference(PCT Practitioner | PCT Organization) Practitioner or organization
    ele-1: All FHIR elements must have a @value or children
    ..... role 1..1 CodeableConcept Function within the team
    Binding: PCT Care Team Role Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTCareTeamRole
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: referring
    ... Slices for supportingInfo S 0..* BackboneElement Supporting information
    Slice: Unordered, Open by value:category
    ele-1: All FHIR elements must have a @value or children
    .... supportingInfo:All Slices Content/Rules for all slices
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Information instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Binding: PCT Supporting Info Type Value Set (extensible)
    ele-1: All FHIR elements must have a @value or children
    .... supportingInfo:serviceFacility S 0..1 BackboneElement Service Facility
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Information instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Binding: PCT Supporting Info Type Value Set (extensible)
    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTSupportingInfoType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: servicefacility
    ..... Slices for value[x] 1..1 Reference(Resource) Data to be provided
    Slice: Unordered, Closed by type:$this
    ele-1: All FHIR elements must have a @value or children
    ...... value[x]:valueReference 1..1 Reference(PCT Organization) Data to be provided
    ele-1: All FHIR elements must have a @value or children
    .... supportingInfo:claimFrequency S 0..1 BackboneElement Claim Frequency
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Information instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Binding: PCT Supporting Info Type Value Set (extensible)
    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTSupportingInfoType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: claimFrequency
    ..... code 1..1 CodeableConcept Type of information
    Binding: PCT GFE Frequency Code Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    ... Slices for diagnosis S 0..* BackboneElement Pertinent diagnosis information
    Slice: Unordered, Open by value:type
    ele-1: All FHIR elements must have a @value or children
    .... diagnosis:All Slices Content/Rules for all slices
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Diagnosis instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... diagnosis[x] 1..1 Nature of illness or problem
    Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.


    ele-1: All FHIR elements must have a @value or children
    ...... diagnosisCodeableConcept CodeableConcept
    ...... diagnosisReference Reference(Condition)
    ..... type S 0..* CodeableConcept Timing or nature of the diagnosis
    Binding: PCT Diagnosis Type Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    .... diagnosis:principal S 0..1 BackboneElement Principal Diagnosis - Must Support means the information source SHALL be capable of populating and SHALL populate if available and permitted.
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Diagnosis instance identifier
    ele-1: All FHIR elements must have a @value or children
    Required Pattern: 1
    ..... diagnosis[x] 1..1 CodeableConcept Nature of illness or problem
    Binding: PCT ICD-10 Diagnostic Codes (required)
    ele-1: All FHIR elements must have a @value or children
    ..... type S 1..1 CodeableConcept Timing or nature of the diagnosis
    Binding: PCT Diagnosis Type Value Set (required)
    ele-1: All FHIR elements must have a @value or children

    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/ex-diagnosistype
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: principal
    .... diagnosis:other S 0..11 BackboneElement Pertinent diagnosis information
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Diagnosis instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... diagnosis[x] 1..1 CodeableConcept Nature of illness or problem
    Binding: PCT ICD-10 Diagnostic Codes (required)
    ele-1: All FHIR elements must have a @value or children
    ..... type S 1..1 CodeableConcept Timing or nature of the diagnosis
    Binding: PCT Diagnosis Type Value Set (required)
    ele-1: All FHIR elements must have a @value or children

    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDiagnosisType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: other
    ... Slices for procedure S 0..* BackboneElement Clinical procedures performed
    Slice: Unordered, Open by value:type
    ele-1: All FHIR elements must have a @value or children
    .... procedure:All Slices Content/Rules for all slices
    ..... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Procedure instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... type S 0..* CodeableConcept Category of Procedure
    Binding: PCT Procedure Type Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    ..... procedure[x] 1..1 Specific clinical procedure
    Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.


    ele-1: All FHIR elements must have a @value or children
    ...... procedureCodeableConcept CodeableConcept
    ...... procedureReference Reference(Procedure)
    .... procedure:anesthesiaRelated S 0..2 BackboneElement Clinical procedures performed
    ele-1: All FHIR elements must have a @value or children
    ..... Slices for extension Content/Rules for all slices
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Procedure instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... type S 1..1 CodeableConcept Category of Procedure
    Binding: PCT Procedure Type Value Set (required)
    ele-1: All FHIR elements must have a @value or children

    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTProcedureType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: procedureRequiringAnesthesia
    ..... procedure[x] 1..1 CodeableConcept Specific clinical procedure
    Binding: PCT CMS HCPCS and AMA CPT Procedure Surgical Codes (required)
    ele-1: All FHIR elements must have a @value or children
    .... procedure:other S 0..24 BackboneElement Clinical procedures performed
    ele-1: All FHIR elements must have a @value or children
    ..... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Procedure instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... type S 0..* CodeableConcept Category of Procedure
    Binding: PCT Procedure Type Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    ..... procedure[x] 1..1 Specific clinical procedure
    Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.


    ele-1: All FHIR elements must have a @value or children
    ...... procedureCodeableConcept CodeableConcept
    ...... procedureReference Reference(Procedure)
    ... insurance Σ 1..* BackboneElement Patient insurance information
    ele-1: All FHIR elements must have a @value or children
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... sequence Σ 1..1 positiveInt Insurance instance identifier
    ele-1: All FHIR elements must have a @value or children
    .... focal Σ 1..1 boolean Coverage to be used for adjudication
    ele-1: All FHIR elements must have a @value or children
    .... coverage Σ 1..1 Reference(PCT Coverage) Insurance information
    ele-1: All FHIR elements must have a @value or children
    ..... Slices for extension Content/Rules for all slices
    ...... dataAbsentReason S 0..1 code Coverage may be not applicable if estimate is for self-pay or uninsured
    URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
    Binding: DataAbsentReason (required)
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... preAuthRef 0..2 string Prior authorization reference number
    ele-1: All FHIR elements must have a @value or children
    ... item 1..50 BackboneElement Product or service provided
    ele-1: All FHIR elements must have a @value or children
    .... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... referralNumber S 0..11 string Referral Number
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/referralNumber
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... gfeBillingProviderLineItemCtrlNum S 0..1 Identifier Extension
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeBillingProviderLineItemCtrlNum
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... ProviderEventMethodology S 0..1 string Provider Event Methodology
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerEventMethodology
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... sequence 1..1 positiveInt Item instance identifier
    ele-1: All FHIR elements must have a @value or children
    .... careTeamSequence S 0..* positiveInt Applicable careTeam members
    ele-1: All FHIR elements must have a @value or children
    .... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
    Binding: Claim Medical Product or Service Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    .... modifier S 0..4 CodeableConcept Product or service billing modifiers
    Binding: PCT GFE Item CPT - HCPCS Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    .... serviced[x] S 1..1 This is the planned or estimated date(s)s of service
    ele-1: All FHIR elements must have a @value or children
    ..... servicedDate date
    ..... servicedPeriod Period
    .... location[x] 1..1 CodeableConcept Place of service or where product was supplied
    Binding: PCT GFE CMS Place of Service Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    .... quantity 1..1 SimpleQuantity Count of products or services
    ele-1: All FHIR elements must have a @value or children
    .... unitPrice 1..1 Money Fee, charge or cost per item
    ele-1: All FHIR elements must have a @value or children
    .... net 1..1 Money Total charge amount for the service line
    ele-1: All FHIR elements must have a @value or children
    .... detail S 0..* BackboneElement Drug Identification Information
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Item instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
    Binding: Claim Medical Product or Service Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    ..... quantity S 0..1 SimpleQuantity Count of products or services
    ele-1: All FHIR elements must have a @value or children
    ... total 1..1 Money Total GFE Charges Submitted
    ele-1: All FHIR elements must have a @value or children

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Claim.identifier:PLAC.userequiredIdentifierUse
    http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
    from the FHIR Standard
    Claim.identifier:PLAC.typeextensiblePattern: PLAC("Placer Identifier")
    http://hl7.org/fhir/ValueSet/identifier-type
    from the FHIR Standard
    Claim.identifier:INTER.userequiredIdentifierUse
    http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
    from the FHIR Standard
    Claim.identifier:INTER.typeextensiblePattern: INTER("Intermediary System Identifier")
    http://hl7.org/fhir/ValueSet/identifier-type
    from the FHIR Standard
    Claim.statusrequiredFinancialResourceStatusCodes
    http://hl7.org/fhir/ValueSet/fm-status|4.0.1
    from the FHIR Standard
    Claim.typeextensiblePattern: professional
    http://hl7.org/fhir/ValueSet/claim-type
    from the FHIR Standard
    Claim.userequiredPattern: predetermination
    http://hl7.org/fhir/ValueSet/claim-use|4.0.1
    from the FHIR Standard
    Claim.priorityrequiredProcessPriorityCodes
    http://hl7.org/fhir/ValueSet/process-priority
    from the FHIR Standard
    Claim.payee.typeexampleClaim Payee Type Codes
    http://hl7.org/fhir/ValueSet/payeetype
    from the FHIR Standard
    Claim.careTeam.rolerequiredPCTCareTeamRoleVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTCareTeamRoleVS
    from this IG
    Claim.careTeam.qualificationrequiredUSCoreProviderRoleNucc
    http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role
    Claim.careTeam:rendering.rolerequiredPattern: rendering
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTCareTeamRoleVS
    from this IG
    Claim.careTeam:rendering.qualificationrequiredUSCoreProviderRoleNucc
    http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role
    Claim.careTeam:referring.rolerequiredPattern: referring
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTCareTeamRoleVS
    from this IG
    Claim.supportingInfo.categoryextensiblePCTSupportingInfoTypeVS (a valid code from PCT GFE Supporting Info Type Code System)
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTSupportingInfoTypeVS
    from this IG
    Claim.supportingInfo:serviceFacility.categoryextensiblePattern: servicefacility
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTSupportingInfoTypeVS
    from this IG
    Claim.supportingInfo:claimFrequency.categoryextensiblePattern: claimFrequency
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTSupportingInfoTypeVS
    from this IG
    Claim.supportingInfo:claimFrequency.coderequiredPCTGFEFrequencyVS (a valid code from PCT GFE Frequency Code System)
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFEFrequencyVS
    from this IG
    Claim.diagnosis.diagnosis[x]exampleICD-10Codes
    http://hl7.org/fhir/ValueSet/icd-10
    from the FHIR Standard
    Claim.diagnosis.typerequiredPCTDiagnosisTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosisTypeVS
    from this IG
    Claim.diagnosis:principal.diagnosis[x]requiredPCTDiagnosticCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosticCodes
    from this IG
    Claim.diagnosis:principal.typerequiredPattern: principal
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosisTypeVS
    from this IG
    Claim.diagnosis:other.diagnosis[x]requiredPCTDiagnosticCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosticCodes
    from this IG
    Claim.diagnosis:other.typerequiredPattern: other
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosisTypeVS
    from this IG
    Claim.procedure.typerequiredPCTProcedureTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureTypeVS
    from this IG
    Claim.procedure.procedure[x]exampleICD-10ProcedureCodes
    http://hl7.org/fhir/ValueSet/icd-10-procedures
    from the FHIR Standard
    Claim.procedure:anesthesiaRelated.typerequiredPattern: procedureRequiringAnesthesia
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureTypeVS
    from this IG
    Claim.procedure:anesthesiaRelated.procedure[x]requiredPCTProcedureSurgicalCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureSurgicalCodes
    from this IG
    Claim.procedure:other.typerequiredPCTProcedureTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureTypeVS
    from this IG
    Claim.procedure:other.procedure[x]exampleICD-10ProcedureCodes
    http://hl7.org/fhir/ValueSet/icd-10-procedures
    from the FHIR Standard
    Claim.item.productOrServicerequiredUSClaimMedicalProductOrServiceCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/USClaimMedicalProductOrServiceCodes
    from this IG
    Claim.item.modifierrequiredPCTGFEItemCptHcpcsVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFEItemCptHcpcsVS
    from this IG
    Claim.item.location[x]requiredPCTGFECMSPOS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFECMSPOS
    from this IG
    Claim.item.detail.productOrServicerequiredUSClaimMedicalProductOrServiceCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/USClaimMedicalProductOrServiceCodes
    from this IG

    This structure is derived from Claim

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Claim Claim
    ... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    .... gfeServiceLinkingInfo S 0..1 (Complex) GFE Service Linking Information
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
    .... providerEventMethodology S 0..1 string Provider event collection methodology
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerEventMethodology
    .... gfeDisclaimer S 0..* string Disclaimers the patient should be made aware of regarding the providers estimate
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeDisclaimer
    ... Slices for identifier 1..* Identifier Business Identifier for claim
    Slice: Unordered, Open by value:type
    .... identifier:PLAC 1..1 Identifier Provider Assigned Identifier for GFE Claim
    ..... type 1..1 CodeableConcept Description of identifier
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: PLAC
    ....... display 1..1 string Representation defined by the system
    Fixed Value: Placer Identifier
    ..... system S 0..1 uri The namespace for the identifier value
    ..... value 1..1 string The value that is unique
    .... identifier:INTER 0..* Identifier Intermediary System Identifier
    ..... type 1..1 CodeableConcept Description of identifier
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTIdentifierType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: INTER
    ....... display 1..1 string Representation defined by the system
    Fixed Value: Intermediary System Identifier
    ... type 1..1 CodeableConcept Category or discipline
    Required Pattern: At least the following
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: professional
    ... use 1..1 code claim | preauthorization | predetermination
    Required Pattern: predetermination
    ... patient 1..1 Reference(HRex Patient Demographics) The recipient of the products and services
    ... insurer S 0..1 Reference(PCT Organization) Required if insured estimate
    ... provider 1..1 Reference(PCT Organization | PCT Practitioner) Billing provider - party responsible for the GFE
    .... extension 1..* Extension Extension
    .... Slices for extension Content/Rules for all slices
    ..... providerTaxonomy 1..1 CodeableConcept Provider taxonomy codes consisting of NUCC Health Care Provider Taxonomy Code Set for providers
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerTaxonomy
    Binding: US Core Provider Role (NUCC) (extensible)
    ..... consentForBalanceBilling S 0..1 boolean Extension
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeConsentForBalanceBilling
    ... priority 1..1 CodeableConcept Desired processing ugency
    Binding: ProcessPriorityCodes (required)
    ... payee S 0..1 BackboneElement Recipient of benefits payable
    .... party 0..1 Reference(PCT Practitioner | PCT Organization) Recipient reference
    ... referral
    .... extension 1..* Extension Extension
    .... Slices for extension Content/Rules for all slices
    ..... referralNumber 1..1 string Referral Number
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/referralNumber
    ... Slices for careTeam S 0..* BackboneElement Members of the care team
    Slice: Unordered, Open by value:role
    .... careTeam:All Slices Content/Rules for all slices
    ..... provider 1..1 Reference(PCT Practitioner | PCT Organization) Practitioner or organization
    ..... role 1..1 CodeableConcept Function within the team
    Binding: PCT Care Team Role Value Set (required)
    ..... qualification 0..1 CodeableConcept Practitioner credential or specialization
    Binding: US Core Provider Role (NUCC) (required)
    .... careTeam:rendering 0..* BackboneElement Members of the care team
    ..... role 1..1 CodeableConcept Function within the team
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTCareTeamRole
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: rendering
    ..... qualification 1..1 CodeableConcept Practitioner credential or specialization - must provide a taxonomy code for the Professional case
    .... careTeam:referring 0..1 BackboneElement Members of the care team
    ..... role 1..1 CodeableConcept Function within the team
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTCareTeamRole
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: referring
    ... Slices for supportingInfo S 0..* BackboneElement Supporting information
    Slice: Unordered, Open by value:category
    .... supportingInfo:All Slices Content/Rules for all slices
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Binding: PCT Supporting Info Type Value Set (extensible)
    .... supportingInfo:serviceFacility S 0..1 BackboneElement Service Facility
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTSupportingInfoType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: servicefacility
    ..... Slices for value[x] 1..1 Reference(Resource) Data to be provided
    Slice: Unordered, Open by type:$this
    ...... value[x]:valueReference 1..1 Reference(PCT Organization) Data to be provided
    .... supportingInfo:claimFrequency S 0..1 BackboneElement Claim Frequency
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTSupportingInfoType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: claimFrequency
    ..... code 1..1 CodeableConcept Type of information
    Binding: PCT GFE Frequency Code Value Set (required)
    ... Slices for diagnosis S 0..* BackboneElement Pertinent diagnosis information
    Slice: Unordered, Open by value:type
    .... diagnosis:All Slices Content/Rules for all slices
    ..... type S 0..* CodeableConcept Timing or nature of the diagnosis
    Binding: PCT Diagnosis Type Value Set (required)
    .... diagnosis:principal S 0..1 BackboneElement Principal Diagnosis - Must Support means the information source SHALL be capable of populating and SHALL populate if available and permitted.
    ..... sequence 1..1 positiveInt Diagnosis instance identifier
    Required Pattern: 1
    ..... diagnosis[x] 1..1 CodeableConcept Nature of illness or problem
    Binding: PCT ICD-10 Diagnostic Codes (required)
    ..... type 1..1 CodeableConcept Timing or nature of the diagnosis
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/ex-diagnosistype
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: principal
    .... diagnosis:other S 0..11 BackboneElement Pertinent diagnosis information
    ..... diagnosis[x] 1..1 CodeableConcept Nature of illness or problem
    Binding: PCT ICD-10 Diagnostic Codes (required)
    ..... type 1..1 CodeableConcept Timing or nature of the diagnosis
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDiagnosisType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: other
    ... Slices for procedure S 0..* BackboneElement Clinical procedures performed
    Slice: Unordered, Open by value:type
    .... procedure:All Slices Content/Rules for all slices
    ..... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ..... type S 0..* CodeableConcept Category of Procedure
    Binding: PCT Procedure Type Value Set (required)
    .... procedure:anesthesiaRelated S 0..2 BackboneElement Clinical procedures performed
    ..... Slices for extension Content/Rules for all slices
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ..... type 1..1 CodeableConcept Category of Procedure
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTProcedureType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: procedureRequiringAnesthesia
    ..... procedure[x] 1..1 CodeableConcept Specific clinical procedure
    Binding: PCT CMS HCPCS and AMA CPT Procedure Surgical Codes (required)
    .... procedure:other S 0..24 BackboneElement Clinical procedures performed
    ... insurance
    .... coverage 1..1 Reference(PCT Coverage) Insurance information
    ..... Slices for extension Content/Rules for all slices
    ...... dataAbsentReason S 0..1 code Coverage may be not applicable if estimate is for self-pay or uninsured
    URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
    Binding: DataAbsentReason (required)
    .... preAuthRef 0..2 string Prior authorization reference number
    ... accident
    .... location[x] 0..1 Address Where the event occurred
    ..... country 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
    Binding: Iso3166-1-2 (required)
    ... item 1..50 BackboneElement Product or service provided
    .... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ..... referralNumber S 0..11 string Referral Number
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/referralNumber
    ..... gfeBillingProviderLineItemCtrlNum S 0..1 Identifier Extension
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeBillingProviderLineItemCtrlNum
    ..... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ..... ProviderEventMethodology S 0..1 string Provider Event Methodology
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerEventMethodology
    .... careTeamSequence S 0..* positiveInt Applicable careTeam members
    .... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
    Binding: Claim Medical Product or Service Value Set (required)
    .... modifier S 0..4 CodeableConcept Product or service billing modifiers
    Binding: PCT GFE Item CPT - HCPCS Value Set (required)
    .... serviced[x] S 1..1 date, Period This is the planned or estimated date(s)s of service
    .... location[x] 1..1 CodeableConcept Place of service or where product was supplied
    Binding: PCT GFE CMS Place of Service Value Set (required)
    .... quantity 1..1 SimpleQuantity Count of products or services
    .... unitPrice 1..1 Money Fee, charge or cost per item
    .... net 1..1 Money Total charge amount for the service line
    .... detail S 0..* BackboneElement Drug Identification Information
    ..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
    Binding: Claim Medical Product or Service Value Set (required)
    ..... quantity S 0..1 SimpleQuantity Count of products or services
    ... total 1..1 Money Total GFE Charges Submitted

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Claim.priorityrequiredProcessPriorityCodes
    http://hl7.org/fhir/ValueSet/process-priority
    from the FHIR Standard
    Claim.careTeam.rolerequiredPCTCareTeamRoleVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTCareTeamRoleVS
    from this IG
    Claim.careTeam.qualificationrequiredUSCoreProviderRoleNucc
    http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role
    Claim.supportingInfo.categoryextensiblePCTSupportingInfoTypeVS (a valid code from PCT GFE Supporting Info Type Code System)
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTSupportingInfoTypeVS
    from this IG
    Claim.supportingInfo:claimFrequency.coderequiredPCTGFEFrequencyVS (a valid code from PCT GFE Frequency Code System)
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFEFrequencyVS
    from this IG
    Claim.diagnosis.typerequiredPCTDiagnosisTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosisTypeVS
    from this IG
    Claim.diagnosis:principal.diagnosis[x]requiredPCTDiagnosticCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosticCodes
    from this IG
    Claim.diagnosis:other.diagnosis[x]requiredPCTDiagnosticCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosticCodes
    from this IG
    Claim.procedure.typerequiredPCTProcedureTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureTypeVS
    from this IG
    Claim.procedure:anesthesiaRelated.procedure[x]requiredPCTProcedureSurgicalCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureSurgicalCodes
    from this IG
    Claim.accident.location[x].countryrequiredIso3166-1-2
    http://hl7.org/fhir/ValueSet/iso3166-1-2
    from the FHIR Standard
    Claim.item.productOrServicerequiredUSClaimMedicalProductOrServiceCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/USClaimMedicalProductOrServiceCodes
    from this IG
    Claim.item.modifierrequiredPCTGFEItemCptHcpcsVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFEItemCptHcpcsVS
    from this IG
    Claim.item.location[x]requiredPCTGFECMSPOS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFECMSPOS
    from this IG
    Claim.item.detail.productOrServicerequiredUSClaimMedicalProductOrServiceCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/USClaimMedicalProductOrServiceCodes
    from this IG
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Claim 0..* Claim Claim, Pre-determination or Pre-authorization
    ... id Σ 0..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    ... contained 0..* Resource Contained, inline Resources
    ... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    .... gfeServiceLinkingInfo S 0..1 (Complex) GFE Service Linking Information
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
    .... providerEventMethodology S 0..1 string Provider event collection methodology
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerEventMethodology
    .... gfeDisclaimer S 0..* string Disclaimers the patient should be made aware of regarding the providers estimate
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeDisclaimer
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... Slices for identifier 1..* Identifier Business Identifier for claim
    Slice: Unordered, Open by value:type
    .... identifier:PLAC 1..1 Identifier Provider Assigned Identifier for GFE Claim
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
    Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

    ..... type Σ 1..1 CodeableConcept Description of identifier
    Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: PLAC
    ....... display 1..1 string Representation defined by the system
    Fixed Value: Placer Identifier
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... system SΣ 0..1 uri The namespace for the identifier value
    Example General: http://www.acme.com/identifiers/patient
    ..... value Σ 1..1 string The value that is unique
    Example General: 123456
    ..... period Σ 0..1 Period Time period when id is/was valid for use
    ..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
    .... identifier:INTER 0..* Identifier Intermediary System Identifier
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
    Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

    ..... type Σ 1..1 CodeableConcept Description of identifier
    Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTIdentifierType
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: INTER
    ....... display 1..1 string Representation defined by the system
    Fixed Value: Intermediary System Identifier
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... system Σ 0..1 uri The namespace for the identifier value
    Example General: http://www.acme.com/identifiers/patient
    ..... value Σ 0..1 string The value that is unique
    Example General: 123456
    ..... period Σ 0..1 Period Time period when id is/was valid for use
    ..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
    ... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
    Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.

    ... type Σ 1..1 CodeableConcept Category or discipline
    Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.


    Required Pattern: At least the following
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
    ..... version 0..1 string Version of the system - if relevant
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: professional
    ..... display 0..1 string Representation defined by the system
    ..... userSelected 0..1 boolean If this coding was chosen directly by the user
    .... text 0..1 string Plain text representation of the concept
    ... subType 0..1 CodeableConcept More granular claim type
    Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode.

    ... use Σ 1..1 code claim | preauthorization | predetermination
    Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.


    Required Pattern: predetermination
    ... patient Σ 1..1 Reference(HRex Patient Demographics) The recipient of the products and services
    ... billablePeriod Σ 0..1 Period Relevant time frame for the claim
    ... created Σ 1..1 dateTime Resource creation date
    ... enterer 0..1 Reference(Practitioner | PractitionerRole) Author of the claim
    ... insurer SΣ 0..1 Reference(PCT Organization) Required if insured estimate
    ... provider Σ 1..1 Reference(PCT Organization | PCT Practitioner) Billing provider - party responsible for the GFE
    .... id 0..1 string Unique id for inter-element referencing
    .... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ..... providerTaxonomy 1..1 CodeableConcept Provider taxonomy codes consisting of NUCC Health Care Provider Taxonomy Code Set for providers
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerTaxonomy
    Binding: US Core Provider Role (NUCC) (extensible)
    ..... consentForBalanceBilling S 0..1 boolean Extension
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeConsentForBalanceBilling
    .... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
    .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... priority Σ 1..1 CodeableConcept Desired processing ugency
    Binding: ProcessPriorityCodes (required)
    ... fundsReserve 0..1 CodeableConcept For whom to reserve funds
    Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).

    ... related 0..* BackboneElement Prior or corollary claims
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... claim 0..1 Reference(Claim) Reference to the related claim
    .... relationship 0..1 CodeableConcept How the reference claim is related
    Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.

    .... reference 0..1 Identifier File or case reference
    ... prescription 0..1 Reference(DeviceRequest | MedicationRequest | VisionPrescription) Prescription authorizing services and products
    ... originalPrescription 0..1 Reference(DeviceRequest | MedicationRequest | VisionPrescription) Original prescription if superseded by fulfiller
    ... payee S 0..1 BackboneElement Recipient of benefits payable
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... type 1..1 CodeableConcept Category of recipient
    Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.

    .... party 0..1 Reference(PCT Practitioner | PCT Organization) Recipient reference
    ... referral 0..1 Reference(ServiceRequest) Treatment referral
    .... id 0..1 string Unique id for inter-element referencing
    .... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ..... referralNumber 1..1 string Referral Number
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/referralNumber
    .... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
    .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... facility 0..1 Reference(Location) Servicing facility
    ... Slices for careTeam S 0..* BackboneElement Members of the care team
    Slice: Unordered, Open by value:role
    .... careTeam:All Slices Content/Rules for all slices
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Order of care team
    ..... provider 1..1 Reference(PCT Practitioner | PCT Organization) Practitioner or organization
    ..... responsible 0..1 boolean Indicator of the lead practitioner
    ..... role 1..1 CodeableConcept Function within the team
    Binding: PCT Care Team Role Value Set (required)
    ..... qualification 0..1 CodeableConcept Practitioner credential or specialization
    Binding: US Core Provider Role (NUCC) (required)
    .... careTeam:rendering 0..* BackboneElement Members of the care team
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Order of care team
    ..... provider 1..1 Reference(PCT Practitioner | PCT Organization) Practitioner or organization
    ..... responsible 0..1 boolean Indicator of the lead practitioner
    ..... role 1..1 CodeableConcept Function within the team
    Binding: PCT Care Team Role Value Set (required)
    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTCareTeamRole
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: rendering
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... qualification 1..1 CodeableConcept Practitioner credential or specialization - must provide a taxonomy code for the Professional case
    Binding: US Core Provider Role (NUCC) (required)
    .... careTeam:referring 0..1 BackboneElement Members of the care team
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Order of care team
    ..... provider 1..1 Reference(PCT Practitioner | PCT Organization) Practitioner or organization
    ..... responsible 0..1 boolean Indicator of the lead practitioner
    ..... role 1..1 CodeableConcept Function within the team
    Binding: PCT Care Team Role Value Set (required)
    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTCareTeamRole
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: referring
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... qualification 0..1 CodeableConcept Practitioner credential or specialization
    Binding: US Core Provider Role (NUCC) (required)
    ... Slices for supportingInfo S 0..* BackboneElement Supporting information
    Slice: Unordered, Open by value:category
    .... supportingInfo:All Slices Content/Rules for all slices
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Information instance identifier
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Binding: PCT Supporting Info Type Value Set (extensible)
    ..... code 0..1 CodeableConcept Type of information
    Binding: ExceptionCodes (example): The valuset used for additional information codes.

    ..... timing[x] 0..1 When it occurred
    ...... timingDate date
    ...... timingPeriod Period
    ..... value[x] 0..1 Data to be provided
    ...... valueBoolean boolean
    ...... valueString string
    ...... valueQuantity Quantity
    ...... valueAttachment Attachment
    ...... valueReference Reference(Resource)
    ..... reason 0..1 CodeableConcept Explanation for the information
    Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

    .... supportingInfo:serviceFacility S 0..1 BackboneElement Service Facility
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Information instance identifier
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Binding: PCT Supporting Info Type Value Set (extensible)
    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTSupportingInfoType
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: servicefacility
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... code 0..1 CodeableConcept Type of information
    Binding: ExceptionCodes (example): The valuset used for additional information codes.

    ..... timing[x] 0..1 When it occurred
    ...... timingDate date
    ...... timingPeriod Period
    ..... Slices for value[x] 1..1 Reference(Resource) Data to be provided
    Slice: Unordered, Closed by type:$this
    ...... value[x]:valueReference 1..1 Reference(PCT Organization) Data to be provided
    ..... reason 0..1 CodeableConcept Explanation for the information
    Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

    .... supportingInfo:claimFrequency S 0..1 BackboneElement Claim Frequency
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Information instance identifier
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Binding: PCT Supporting Info Type Value Set (extensible)
    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTSupportingInfoType
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: claimFrequency
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... code 1..1 CodeableConcept Type of information
    Binding: PCT GFE Frequency Code Value Set (required)
    ..... timing[x] 0..1 When it occurred
    ...... timingDate date
    ...... timingPeriod Period
    ..... value[x] 0..1 Data to be provided
    ...... valueBoolean boolean
    ...... valueString string
    ...... valueQuantity Quantity
    ...... valueAttachment Attachment
    ...... valueReference Reference(Resource)
    ..... reason 0..1 CodeableConcept Explanation for the information
    Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

    ... Slices for diagnosis S 0..* BackboneElement Pertinent diagnosis information
    Slice: Unordered, Open by value:type
    .... diagnosis:All Slices Content/Rules for all slices
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Diagnosis instance identifier
    ..... diagnosis[x] 1..1 Nature of illness or problem
    Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.

    ...... diagnosisCodeableConcept CodeableConcept
    ...... diagnosisReference Reference(Condition)
    ..... type S 0..* CodeableConcept Timing or nature of the diagnosis
    Binding: PCT Diagnosis Type Value Set (required)
    ..... onAdmission 0..1 CodeableConcept Present on admission
    Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.

    ..... packageCode 0..1 CodeableConcept Package billing code
    Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.

    .... diagnosis:principal S 0..1 BackboneElement Principal Diagnosis - Must Support means the information source SHALL be capable of populating and SHALL populate if available and permitted.
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Diagnosis instance identifier
    Required Pattern: 1
    ..... diagnosis[x] 1..1 CodeableConcept Nature of illness or problem
    Binding: PCT ICD-10 Diagnostic Codes (required)
    ..... type S 1..1 CodeableConcept Timing or nature of the diagnosis
    Binding: PCT Diagnosis Type Value Set (required)

    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/ex-diagnosistype
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: principal
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... onAdmission 0..1 CodeableConcept Present on admission
    Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.

    ..... packageCode 0..1 CodeableConcept Package billing code
    Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.

    .... diagnosis:other S 0..11 BackboneElement Pertinent diagnosis information
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Diagnosis instance identifier
    ..... diagnosis[x] 1..1 CodeableConcept Nature of illness or problem
    Binding: PCT ICD-10 Diagnostic Codes (required)
    ..... type S 1..1 CodeableConcept Timing or nature of the diagnosis
    Binding: PCT Diagnosis Type Value Set (required)

    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDiagnosisType
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: other
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... onAdmission 0..1 CodeableConcept Present on admission
    Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.

    ..... packageCode 0..1 CodeableConcept Package billing code
    Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.

    ... Slices for procedure S 0..* BackboneElement Clinical procedures performed
    Slice: Unordered, Open by value:type
    .... procedure:All Slices Content/Rules for all slices
    ..... id 0..1 string Unique id for inter-element referencing
    ..... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Procedure instance identifier
    ..... type S 0..* CodeableConcept Category of Procedure
    Binding: PCT Procedure Type Value Set (required)
    ..... date 0..1 dateTime When the procedure was performed
    ..... procedure[x] 1..1 Specific clinical procedure
    Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.

    ...... procedureCodeableConcept CodeableConcept
    ...... procedureReference Reference(Procedure)
    ..... udi 0..* Reference(Device) Unique device identifier
    .... procedure:anesthesiaRelated S 0..2 BackboneElement Clinical procedures performed
    ..... id 0..1 string Unique id for inter-element referencing
    ..... Slices for extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Procedure instance identifier
    ..... type S 1..1 CodeableConcept Category of Procedure
    Binding: PCT Procedure Type Value Set (required)

    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTProcedureType
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: procedureRequiringAnesthesia
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... date 0..1 dateTime When the procedure was performed
    ..... procedure[x] 1..1 CodeableConcept Specific clinical procedure
    Binding: PCT CMS HCPCS and AMA CPT Procedure Surgical Codes (required)
    ..... udi 0..* Reference(Device) Unique device identifier
    .... procedure:other S 0..24 BackboneElement Clinical procedures performed
    ..... id 0..1 string Unique id for inter-element referencing
    ..... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Procedure instance identifier
    ..... type S 0..* CodeableConcept Category of Procedure
    Binding: PCT Procedure Type Value Set (required)
    ..... date 0..1 dateTime When the procedure was performed
    ..... procedure[x] 1..1 Specific clinical procedure
    Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.

    ...... procedureCodeableConcept CodeableConcept
    ...... procedureReference Reference(Procedure)
    ..... udi 0..* Reference(Device) Unique device identifier
    ... insurance Σ 1..* BackboneElement Patient insurance information
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... sequence Σ 1..1 positiveInt Insurance instance identifier
    .... focal Σ 1..1 boolean Coverage to be used for adjudication
    .... identifier 0..1 Identifier Pre-assigned Claim number
    .... coverage Σ 1..1 Reference(PCT Coverage) Insurance information
    ..... id 0..1 string Unique id for inter-element referencing
    ..... Slices for extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... dataAbsentReason S 0..1 code Coverage may be not applicable if estimate is for self-pay or uninsured
    URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
    Binding: DataAbsentReason (required)
    ..... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
    ..... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

    ..... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    ..... display Σ 0..1 string Text alternative for the resource
    .... businessArrangement 0..1 string Additional provider contract number
    .... preAuthRef 0..2 string Prior authorization reference number
    .... claimResponse 0..1 Reference(ClaimResponse) Adjudication results
    ... accident 0..1 BackboneElement Details of the event
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... date 1..1 date When the incident occurred
    .... type 0..1 CodeableConcept The nature of the accident
    Binding: ActIncidentCode (extensible): Type of accident: work place, auto, etc.

    .... location[x] 0..1 Address Where the event occurred
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
    Binding: AddressUse (required): The use of an address.


    Example General: home
    ..... type Σ 0..1 code postal | physical | both
    Binding: AddressType (required): The type of an address (physical / postal).


    Example General: both
    ..... text Σ 0..1 string Text representation of the address
    Example General: 137 Nowhere Street, Erewhon 9132
    ..... line Σ 0..* string Street name, number, direction & P.O. Box etc.
    This repeating element order: The order in which lines should appear in an address label
    Example General: 137 Nowhere Street
    ..... city Σ 0..1 string Name of city, town etc.
    Example General: Erewhon
    ..... district Σ 0..1 string District name (aka county)
    Example General: Madison
    ..... state Σ 0..1 string Sub-unit of country (abbreviations ok)
    ..... postalCode Σ 0..1 string Postal code for area
    Example General: 9132
    ..... country Σ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
    Binding: Iso3166-1-2 (required)
    ..... period Σ 0..1 Period Time period when address was/is in use
    Example General: {"start":"2010-03-23","end":"2010-07-01"}
    ... item 1..50 BackboneElement Product or service provided
    .... id 0..1 string Unique id for inter-element referencing
    .... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ..... referralNumber S 0..11 string Referral Number
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/referralNumber
    ..... gfeBillingProviderLineItemCtrlNum S 0..1 Identifier Extension
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeBillingProviderLineItemCtrlNum
    ..... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ..... ProviderEventMethodology S 0..1 string Provider Event Methodology
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerEventMethodology
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... sequence 1..1 positiveInt Item instance identifier
    .... careTeamSequence S 0..* positiveInt Applicable careTeam members
    .... diagnosisSequence 0..* positiveInt Applicable diagnoses
    .... procedureSequence 0..* positiveInt Applicable procedures
    .... informationSequence 0..* positiveInt Applicable exception and supporting information
    .... revenue 0..1 CodeableConcept Revenue or cost center code
    Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

    .... category 0..1 CodeableConcept Benefit classification
    Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

    .... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
    Binding: Claim Medical Product or Service Value Set (required)
    .... modifier S 0..4 CodeableConcept Product or service billing modifiers
    Binding: PCT GFE Item CPT - HCPCS Value Set (required)
    .... programCode 0..* CodeableConcept Program the product or service is provided under
    Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


    .... serviced[x] S 1..1 This is the planned or estimated date(s)s of service
    ..... servicedDate date
    ..... servicedPeriod Period
    .... location[x] 1..1 CodeableConcept Place of service or where product was supplied
    Binding: PCT GFE CMS Place of Service Value Set (required)
    .... quantity 1..1 SimpleQuantity Count of products or services
    .... unitPrice 1..1 Money Fee, charge or cost per item
    .... factor 0..1 decimal Price scaling factor
    .... net 1..1 Money Total charge amount for the service line
    .... udi 0..* Reference(Device) Unique device identifier
    .... bodySite 0..1 CodeableConcept Anatomical location
    Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.

    .... subSite 0..* CodeableConcept Anatomical sub-location
    Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.


    .... encounter 0..* Reference(Encounter) Encounters related to this billed item
    .... detail S 0..* BackboneElement Drug Identification Information
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Item instance identifier
    ..... revenue 0..1 CodeableConcept Revenue or cost center code
    Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

    ..... category 0..1 CodeableConcept Benefit classification
    Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

    ..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
    Binding: Claim Medical Product or Service Value Set (required)
    ..... modifier 0..* CodeableConcept Service/Product billing modifiers
    Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


    ..... programCode 0..* CodeableConcept Program the product or service is provided under
    Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


    ..... quantity S 0..1 SimpleQuantity Count of products or services
    ..... unitPrice 0..1 Money Fee, charge or cost per item
    ..... factor 0..1 decimal Price scaling factor
    ..... net 0..1 Money Total item cost
    ..... udi 0..* Reference(Device) Unique device identifier
    ..... subDetail 0..* BackboneElement Product or service provided
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ...... sequence 1..1 positiveInt Item instance identifier
    ...... revenue 0..1 CodeableConcept Revenue or cost center code
    Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

    ...... category 0..1 CodeableConcept Benefit classification
    Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

    ...... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
    Binding: USCLSCodes (example): Allowable service and product codes.

    ...... modifier 0..* CodeableConcept Service/Product billing modifiers
    Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


    ...... programCode 0..* CodeableConcept Program the product or service is provided under
    Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


    ...... quantity 0..1 SimpleQuantity Count of products or services
    ...... unitPrice 0..1 Money Fee, charge or cost per item
    ...... factor 0..1 decimal Price scaling factor
    ...... net 0..1 Money Total item cost
    ...... udi 0..* Reference(Device) Unique device identifier
    ... total 1..1 Money Total GFE Charges Submitted

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Claim.languagepreferredCommonLanguages
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Additional Bindings Purpose
    AllLanguages Max Binding
    Claim.identifier:PLAC.userequiredIdentifierUse
    http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
    from the FHIR Standard
    Claim.identifier:PLAC.typeextensiblePattern: PLAC("Placer Identifier")
    http://hl7.org/fhir/ValueSet/identifier-type
    from the FHIR Standard
    Claim.identifier:INTER.userequiredIdentifierUse
    http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
    from the FHIR Standard
    Claim.identifier:INTER.typeextensiblePattern: INTER("Intermediary System Identifier")
    http://hl7.org/fhir/ValueSet/identifier-type
    from the FHIR Standard
    Claim.statusrequiredFinancialResourceStatusCodes
    http://hl7.org/fhir/ValueSet/fm-status|4.0.1
    from the FHIR Standard
    Claim.typeextensiblePattern: professional
    http://hl7.org/fhir/ValueSet/claim-type
    from the FHIR Standard
    Claim.subTypeexampleExampleClaimSubTypeCodes
    http://hl7.org/fhir/ValueSet/claim-subtype
    from the FHIR Standard
    Claim.userequiredPattern: predetermination
    http://hl7.org/fhir/ValueSet/claim-use|4.0.1
    from the FHIR Standard
    Claim.provider.typeextensibleResourceType
    http://hl7.org/fhir/ValueSet/resource-types
    from the FHIR Standard
    Claim.priorityrequiredProcessPriorityCodes
    http://hl7.org/fhir/ValueSet/process-priority
    from the FHIR Standard
    Claim.fundsReserveexampleFunds Reservation Codes
    http://hl7.org/fhir/ValueSet/fundsreserve
    from the FHIR Standard
    Claim.related.relationshipexampleExampleRelatedClaimRelationshipCodes
    http://hl7.org/fhir/ValueSet/related-claim-relationship
    from the FHIR Standard
    Claim.payee.typeexampleClaim Payee Type Codes
    http://hl7.org/fhir/ValueSet/payeetype
    from the FHIR Standard
    Claim.referral.typeextensibleResourceType
    http://hl7.org/fhir/ValueSet/resource-types
    from the FHIR Standard
    Claim.careTeam.rolerequiredPCTCareTeamRoleVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTCareTeamRoleVS
    from this IG
    Claim.careTeam.qualificationrequiredUSCoreProviderRoleNucc
    http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role
    Claim.careTeam:rendering.rolerequiredPattern: rendering
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTCareTeamRoleVS
    from this IG
    Claim.careTeam:rendering.qualificationrequiredUSCoreProviderRoleNucc
    http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role
    Claim.careTeam:referring.rolerequiredPattern: referring
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTCareTeamRoleVS
    from this IG
    Claim.careTeam:referring.qualificationrequiredUSCoreProviderRoleNucc
    http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role
    Claim.supportingInfo.categoryextensiblePCTSupportingInfoTypeVS (a valid code from PCT GFE Supporting Info Type Code System)
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTSupportingInfoTypeVS
    from this IG
    Claim.supportingInfo.codeexampleExceptionCodes
    http://hl7.org/fhir/ValueSet/claim-exception
    from the FHIR Standard
    Claim.supportingInfo.reasonexampleMissingToothReasonCodes
    http://hl7.org/fhir/ValueSet/missing-tooth-reason
    from the FHIR Standard
    Claim.supportingInfo:serviceFacility.categoryextensiblePattern: servicefacility
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTSupportingInfoTypeVS
    from this IG
    Claim.supportingInfo:serviceFacility.codeexampleExceptionCodes
    http://hl7.org/fhir/ValueSet/claim-exception
    from the FHIR Standard
    Claim.supportingInfo:serviceFacility.reasonexampleMissingToothReasonCodes
    http://hl7.org/fhir/ValueSet/missing-tooth-reason
    from the FHIR Standard
    Claim.supportingInfo:claimFrequency.categoryextensiblePattern: claimFrequency
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTSupportingInfoTypeVS
    from this IG
    Claim.supportingInfo:claimFrequency.coderequiredPCTGFEFrequencyVS (a valid code from PCT GFE Frequency Code System)
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFEFrequencyVS
    from this IG
    Claim.supportingInfo:claimFrequency.reasonexampleMissingToothReasonCodes
    http://hl7.org/fhir/ValueSet/missing-tooth-reason
    from the FHIR Standard
    Claim.diagnosis.diagnosis[x]exampleICD-10Codes
    http://hl7.org/fhir/ValueSet/icd-10
    from the FHIR Standard
    Claim.diagnosis.typerequiredPCTDiagnosisTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosisTypeVS
    from this IG
    Claim.diagnosis.onAdmissionexampleExampleDiagnosisOnAdmissionCodes
    http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission
    from the FHIR Standard
    Claim.diagnosis.packageCodeexampleExampleDiagnosisRelatedGroupCodes
    http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup
    from the FHIR Standard
    Claim.diagnosis:principal.diagnosis[x]requiredPCTDiagnosticCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosticCodes
    from this IG
    Claim.diagnosis:principal.typerequiredPattern: principal
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosisTypeVS
    from this IG
    Claim.diagnosis:principal.onAdmissionexampleExampleDiagnosisOnAdmissionCodes
    http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission
    from the FHIR Standard
    Claim.diagnosis:principal.packageCodeexampleExampleDiagnosisRelatedGroupCodes
    http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup
    from the FHIR Standard
    Claim.diagnosis:other.diagnosis[x]requiredPCTDiagnosticCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosticCodes
    from this IG
    Claim.diagnosis:other.typerequiredPattern: other
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosisTypeVS
    from this IG
    Claim.diagnosis:other.onAdmissionexampleExampleDiagnosisOnAdmissionCodes
    http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission
    from the FHIR Standard
    Claim.diagnosis:other.packageCodeexampleExampleDiagnosisRelatedGroupCodes
    http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup
    from the FHIR Standard
    Claim.procedure.typerequiredPCTProcedureTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureTypeVS
    from this IG
    Claim.procedure.procedure[x]exampleICD-10ProcedureCodes
    http://hl7.org/fhir/ValueSet/icd-10-procedures
    from the FHIR Standard
    Claim.procedure:anesthesiaRelated.typerequiredPattern: procedureRequiringAnesthesia
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureTypeVS
    from this IG
    Claim.procedure:anesthesiaRelated.procedure[x]requiredPCTProcedureSurgicalCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureSurgicalCodes
    from this IG
    Claim.procedure:other.typerequiredPCTProcedureTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureTypeVS
    from this IG
    Claim.procedure:other.procedure[x]exampleICD-10ProcedureCodes
    http://hl7.org/fhir/ValueSet/icd-10-procedures
    from the FHIR Standard
    Claim.insurance.coverage.typeextensibleResourceType
    http://hl7.org/fhir/ValueSet/resource-types
    from the FHIR Standard
    Claim.accident.typeextensibleActIncidentCode
    http://terminology.hl7.org/ValueSet/v3-ActIncidentCode
    Claim.accident.location[x].userequiredAddressUse
    http://hl7.org/fhir/ValueSet/address-use|4.0.1
    from the FHIR Standard
    Claim.accident.location[x].typerequiredAddressType
    http://hl7.org/fhir/ValueSet/address-type|4.0.1
    from the FHIR Standard
    Claim.accident.location[x].countryrequiredIso3166-1-2
    http://hl7.org/fhir/ValueSet/iso3166-1-2
    from the FHIR Standard
    Claim.item.revenueexampleExampleRevenueCenterCodes
    http://hl7.org/fhir/ValueSet/ex-revenue-center
    from the FHIR Standard
    Claim.item.categoryexampleBenefitCategoryCodes
    http://hl7.org/fhir/ValueSet/ex-benefitcategory
    from the FHIR Standard
    Claim.item.productOrServicerequiredUSClaimMedicalProductOrServiceCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/USClaimMedicalProductOrServiceCodes
    from this IG
    Claim.item.modifierrequiredPCTGFEItemCptHcpcsVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFEItemCptHcpcsVS
    from this IG
    Claim.item.programCodeexampleExampleProgramReasonCodes
    http://hl7.org/fhir/ValueSet/ex-program-code
    from the FHIR Standard
    Claim.item.location[x]requiredPCTGFECMSPOS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFECMSPOS
    from this IG
    Claim.item.bodySiteexampleOralSiteCodes
    http://hl7.org/fhir/ValueSet/tooth
    from the FHIR Standard
    Claim.item.subSiteexampleSurfaceCodes
    http://hl7.org/fhir/ValueSet/surface
    from the FHIR Standard
    Claim.item.detail.revenueexampleExampleRevenueCenterCodes
    http://hl7.org/fhir/ValueSet/ex-revenue-center
    from the FHIR Standard
    Claim.item.detail.categoryexampleBenefitCategoryCodes
    http://hl7.org/fhir/ValueSet/ex-benefitcategory
    from the FHIR Standard
    Claim.item.detail.productOrServicerequiredUSClaimMedicalProductOrServiceCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/USClaimMedicalProductOrServiceCodes
    from this IG
    Claim.item.detail.modifierexampleModifierTypeCodes
    http://hl7.org/fhir/ValueSet/claim-modifiers
    from the FHIR Standard
    Claim.item.detail.programCodeexampleExampleProgramReasonCodes
    http://hl7.org/fhir/ValueSet/ex-program-code
    from the FHIR Standard
    Claim.item.detail.subDetail.revenueexampleExampleRevenueCenterCodes
    http://hl7.org/fhir/ValueSet/ex-revenue-center
    from the FHIR Standard
    Claim.item.detail.subDetail.categoryexampleBenefitCategoryCodes
    http://hl7.org/fhir/ValueSet/ex-benefitcategory
    from the FHIR Standard
    Claim.item.detail.subDetail.productOrServiceexampleUSCLSCodes
    http://hl7.org/fhir/ValueSet/service-uscls
    from the FHIR Standard
    Claim.item.detail.subDetail.modifierexampleModifierTypeCodes
    http://hl7.org/fhir/ValueSet/claim-modifiers
    from the FHIR Standard
    Claim.item.detail.subDetail.programCodeexampleExampleProgramReasonCodes
    http://hl7.org/fhir/ValueSet/ex-program-code
    from the FHIR Standard

    This structure is derived from Claim

    Summary

    Mandatory: 15 elements(14 nested mandatory elements)
    Must-Support: 28 elements

    Structures

    This structure refers to these other structures:

    Extensions

    This structure refers to these extensions:

    Slices

    This structure defines the following Slices:

    • The element 1 is sliced based on the value of Claim.identifier
    • The element 1 is sliced based on the value of Claim.careTeam
    • The element 1 is sliced based on the value of Claim.supportingInfo
    • The element 1 is sliced based on the value of Claim.supportingInfo.value[x]
    • The element 1 is sliced based on the value of Claim.diagnosis
    • The element 1 is sliced based on the value of Claim.procedure

    Maturity: 2

    Key Elements View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Claim 0..* Claim Claim, Pre-determination or Pre-authorization
    dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    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
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    dom-6: A resource should have narrative for robust management
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ele-1: All FHIR elements must have a @value or children
    ... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... gfeServiceLinkingInfo S 0..1 (Complex) GFE Service Linking Information
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... providerEventMethodology S 0..1 string Provider event collection methodology
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerEventMethodology
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... gfeDisclaimer S 0..* string Disclaimers the patient should be made aware of regarding the providers estimate
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeDisclaimer
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... Slices for identifier 1..* Identifier Business Identifier for claim
    Slice: Unordered, Open by value:type
    ele-1: All FHIR elements must have a @value or children
    .... identifier:PLAC 1..1 Identifier Provider Assigned Identifier for GFE Claim
    ele-1: All FHIR elements must have a @value or children
    ..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
    Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


    ele-1: All FHIR elements must have a @value or children
    ..... type Σ 1..1 CodeableConcept Description of identifier
    Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: PLAC
    ....... display 1..1 string Representation defined by the system
    Fixed Value: Placer Identifier
    ..... system SΣ 0..1 uri The namespace for the identifier value
    ele-1: All FHIR elements must have a @value or children
    Example General: http://www.acme.com/identifiers/patient
    ..... value Σ 1..1 string The value that is unique
    ele-1: All FHIR elements must have a @value or children
    Example General: 123456
    .... identifier:INTER 0..* Identifier Intermediary System Identifier
    ele-1: All FHIR elements must have a @value or children
    ..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
    Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


    ele-1: All FHIR elements must have a @value or children
    ..... type Σ 1..1 CodeableConcept Description of identifier
    Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTIdentifierType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: INTER
    ....... display 1..1 string Representation defined by the system
    Fixed Value: Intermediary System Identifier
    ... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
    Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.


    ele-1: All FHIR elements must have a @value or children
    ... type Σ 1..1 CodeableConcept Category or discipline
    Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.


    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: professional
    ... use Σ 1..1 code claim | preauthorization | predetermination
    Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.


    ele-1: All FHIR elements must have a @value or children
    Required Pattern: predetermination
    ... patient Σ 1..1 Reference(HRex Patient Demographics) The recipient of the products and services
    ele-1: All FHIR elements must have a @value or children
    ... created Σ 1..1 dateTime Resource creation date
    ele-1: All FHIR elements must have a @value or children
    ... insurer SΣ 0..1 Reference(PCT Organization) Required if insured estimate
    ele-1: All FHIR elements must have a @value or children
    ... provider Σ 1..1 Reference(PCT Organization | PCT Practitioner) Billing provider - party responsible for the GFE
    ele-1: All FHIR elements must have a @value or children
    .... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... providerTaxonomy 1..1 CodeableConcept Provider taxonomy codes consisting of NUCC Health Care Provider Taxonomy Code Set for providers
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerTaxonomy
    Binding: US Core Provider Role (NUCC) (extensible)
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... consentForBalanceBilling S 0..1 boolean Extension
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeConsentForBalanceBilling
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... priority Σ 1..1 CodeableConcept Desired processing ugency
    Binding: ProcessPriorityCodes (required)
    ele-1: All FHIR elements must have a @value or children
    ... payee S 0..1 BackboneElement Recipient of benefits payable
    ele-1: All FHIR elements must have a @value or children
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... type 1..1 CodeableConcept Category of recipient
    Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.


    ele-1: All FHIR elements must have a @value or children
    .... party 0..1 Reference(PCT Practitioner | PCT Organization) Recipient reference
    ele-1: All FHIR elements must have a @value or children
    ... Slices for careTeam S 0..* BackboneElement Members of the care team
    Slice: Unordered, Open by value:role
    ele-1: All FHIR elements must have a @value or children
    .... careTeam:All Slices Content/Rules for all slices
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Order of care team
    ele-1: All FHIR elements must have a @value or children
    ..... provider 1..1 Reference(PCT Practitioner | PCT Organization) Practitioner or organization
    ele-1: All FHIR elements must have a @value or children
    ..... role 1..1 CodeableConcept Function within the team
    Binding: PCT Care Team Role Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    ..... qualification 0..1 CodeableConcept Practitioner credential or specialization
    Binding: US Core Provider Role (NUCC) (required)
    ele-1: All FHIR elements must have a @value or children
    .... careTeam:rendering 0..* BackboneElement Members of the care team
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Order of care team
    ele-1: All FHIR elements must have a @value or children
    ..... provider 1..1 Reference(PCT Practitioner | PCT Organization) Practitioner or organization
    ele-1: All FHIR elements must have a @value or children
    ..... role 1..1 CodeableConcept Function within the team
    Binding: PCT Care Team Role Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTCareTeamRole
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: rendering
    ..... qualification 1..1 CodeableConcept Practitioner credential or specialization - must provide a taxonomy code for the Professional case
    Binding: US Core Provider Role (NUCC) (required)
    ele-1: All FHIR elements must have a @value or children
    .... careTeam:referring 0..1 BackboneElement Members of the care team
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Order of care team
    ele-1: All FHIR elements must have a @value or children
    ..... provider 1..1 Reference(PCT Practitioner | PCT Organization) Practitioner or organization
    ele-1: All FHIR elements must have a @value or children
    ..... role 1..1 CodeableConcept Function within the team
    Binding: PCT Care Team Role Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTCareTeamRole
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: referring
    ... Slices for supportingInfo S 0..* BackboneElement Supporting information
    Slice: Unordered, Open by value:category
    ele-1: All FHIR elements must have a @value or children
    .... supportingInfo:All Slices Content/Rules for all slices
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Information instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Binding: PCT Supporting Info Type Value Set (extensible)
    ele-1: All FHIR elements must have a @value or children
    .... supportingInfo:serviceFacility S 0..1 BackboneElement Service Facility
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Information instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Binding: PCT Supporting Info Type Value Set (extensible)
    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTSupportingInfoType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: servicefacility
    ..... Slices for value[x] 1..1 Reference(Resource) Data to be provided
    Slice: Unordered, Closed by type:$this
    ele-1: All FHIR elements must have a @value or children
    ...... value[x]:valueReference 1..1 Reference(PCT Organization) Data to be provided
    ele-1: All FHIR elements must have a @value or children
    .... supportingInfo:claimFrequency S 0..1 BackboneElement Claim Frequency
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Information instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Binding: PCT Supporting Info Type Value Set (extensible)
    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTSupportingInfoType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: claimFrequency
    ..... code 1..1 CodeableConcept Type of information
    Binding: PCT GFE Frequency Code Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    ... Slices for diagnosis S 0..* BackboneElement Pertinent diagnosis information
    Slice: Unordered, Open by value:type
    ele-1: All FHIR elements must have a @value or children
    .... diagnosis:All Slices Content/Rules for all slices
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Diagnosis instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... diagnosis[x] 1..1 Nature of illness or problem
    Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.


    ele-1: All FHIR elements must have a @value or children
    ...... diagnosisCodeableConcept CodeableConcept
    ...... diagnosisReference Reference(Condition)
    ..... type S 0..* CodeableConcept Timing or nature of the diagnosis
    Binding: PCT Diagnosis Type Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    .... diagnosis:principal S 0..1 BackboneElement Principal Diagnosis - Must Support means the information source SHALL be capable of populating and SHALL populate if available and permitted.
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Diagnosis instance identifier
    ele-1: All FHIR elements must have a @value or children
    Required Pattern: 1
    ..... diagnosis[x] 1..1 CodeableConcept Nature of illness or problem
    Binding: PCT ICD-10 Diagnostic Codes (required)
    ele-1: All FHIR elements must have a @value or children
    ..... type S 1..1 CodeableConcept Timing or nature of the diagnosis
    Binding: PCT Diagnosis Type Value Set (required)
    ele-1: All FHIR elements must have a @value or children

    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/ex-diagnosistype
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: principal
    .... diagnosis:other S 0..11 BackboneElement Pertinent diagnosis information
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Diagnosis instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... diagnosis[x] 1..1 CodeableConcept Nature of illness or problem
    Binding: PCT ICD-10 Diagnostic Codes (required)
    ele-1: All FHIR elements must have a @value or children
    ..... type S 1..1 CodeableConcept Timing or nature of the diagnosis
    Binding: PCT Diagnosis Type Value Set (required)
    ele-1: All FHIR elements must have a @value or children

    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDiagnosisType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: other
    ... Slices for procedure S 0..* BackboneElement Clinical procedures performed
    Slice: Unordered, Open by value:type
    ele-1: All FHIR elements must have a @value or children
    .... procedure:All Slices Content/Rules for all slices
    ..... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Procedure instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... type S 0..* CodeableConcept Category of Procedure
    Binding: PCT Procedure Type Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    ..... procedure[x] 1..1 Specific clinical procedure
    Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.


    ele-1: All FHIR elements must have a @value or children
    ...... procedureCodeableConcept CodeableConcept
    ...... procedureReference Reference(Procedure)
    .... procedure:anesthesiaRelated S 0..2 BackboneElement Clinical procedures performed
    ele-1: All FHIR elements must have a @value or children
    ..... Slices for extension Content/Rules for all slices
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Procedure instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... type S 1..1 CodeableConcept Category of Procedure
    Binding: PCT Procedure Type Value Set (required)
    ele-1: All FHIR elements must have a @value or children

    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTProcedureType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: procedureRequiringAnesthesia
    ..... procedure[x] 1..1 CodeableConcept Specific clinical procedure
    Binding: PCT CMS HCPCS and AMA CPT Procedure Surgical Codes (required)
    ele-1: All FHIR elements must have a @value or children
    .... procedure:other S 0..24 BackboneElement Clinical procedures performed
    ele-1: All FHIR elements must have a @value or children
    ..... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Procedure instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... type S 0..* CodeableConcept Category of Procedure
    Binding: PCT Procedure Type Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    ..... procedure[x] 1..1 Specific clinical procedure
    Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.


    ele-1: All FHIR elements must have a @value or children
    ...... procedureCodeableConcept CodeableConcept
    ...... procedureReference Reference(Procedure)
    ... insurance Σ 1..* BackboneElement Patient insurance information
    ele-1: All FHIR elements must have a @value or children
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... sequence Σ 1..1 positiveInt Insurance instance identifier
    ele-1: All FHIR elements must have a @value or children
    .... focal Σ 1..1 boolean Coverage to be used for adjudication
    ele-1: All FHIR elements must have a @value or children
    .... coverage Σ 1..1 Reference(PCT Coverage) Insurance information
    ele-1: All FHIR elements must have a @value or children
    ..... Slices for extension Content/Rules for all slices
    ...... dataAbsentReason S 0..1 code Coverage may be not applicable if estimate is for self-pay or uninsured
    URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
    Binding: DataAbsentReason (required)
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... preAuthRef 0..2 string Prior authorization reference number
    ele-1: All FHIR elements must have a @value or children
    ... item 1..50 BackboneElement Product or service provided
    ele-1: All FHIR elements must have a @value or children
    .... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... referralNumber S 0..11 string Referral Number
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/referralNumber
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... gfeBillingProviderLineItemCtrlNum S 0..1 Identifier Extension
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeBillingProviderLineItemCtrlNum
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... ProviderEventMethodology S 0..1 string Provider Event Methodology
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerEventMethodology
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... sequence 1..1 positiveInt Item instance identifier
    ele-1: All FHIR elements must have a @value or children
    .... careTeamSequence S 0..* positiveInt Applicable careTeam members
    ele-1: All FHIR elements must have a @value or children
    .... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
    Binding: Claim Medical Product or Service Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    .... modifier S 0..4 CodeableConcept Product or service billing modifiers
    Binding: PCT GFE Item CPT - HCPCS Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    .... serviced[x] S 1..1 This is the planned or estimated date(s)s of service
    ele-1: All FHIR elements must have a @value or children
    ..... servicedDate date
    ..... servicedPeriod Period
    .... location[x] 1..1 CodeableConcept Place of service or where product was supplied
    Binding: PCT GFE CMS Place of Service Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    .... quantity 1..1 SimpleQuantity Count of products or services
    ele-1: All FHIR elements must have a @value or children
    .... unitPrice 1..1 Money Fee, charge or cost per item
    ele-1: All FHIR elements must have a @value or children
    .... net 1..1 Money Total charge amount for the service line
    ele-1: All FHIR elements must have a @value or children
    .... detail S 0..* BackboneElement Drug Identification Information
    ele-1: All FHIR elements must have a @value or children
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ..... sequence 1..1 positiveInt Item instance identifier
    ele-1: All FHIR elements must have a @value or children
    ..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
    Binding: Claim Medical Product or Service Value Set (required)
    ele-1: All FHIR elements must have a @value or children
    ..... quantity S 0..1 SimpleQuantity Count of products or services
    ele-1: All FHIR elements must have a @value or children
    ... total 1..1 Money Total GFE Charges Submitted
    ele-1: All FHIR elements must have a @value or children

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Claim.identifier:PLAC.userequiredIdentifierUse
    http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
    from the FHIR Standard
    Claim.identifier:PLAC.typeextensiblePattern: PLAC("Placer Identifier")
    http://hl7.org/fhir/ValueSet/identifier-type
    from the FHIR Standard
    Claim.identifier:INTER.userequiredIdentifierUse
    http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
    from the FHIR Standard
    Claim.identifier:INTER.typeextensiblePattern: INTER("Intermediary System Identifier")
    http://hl7.org/fhir/ValueSet/identifier-type
    from the FHIR Standard
    Claim.statusrequiredFinancialResourceStatusCodes
    http://hl7.org/fhir/ValueSet/fm-status|4.0.1
    from the FHIR Standard
    Claim.typeextensiblePattern: professional
    http://hl7.org/fhir/ValueSet/claim-type
    from the FHIR Standard
    Claim.userequiredPattern: predetermination
    http://hl7.org/fhir/ValueSet/claim-use|4.0.1
    from the FHIR Standard
    Claim.priorityrequiredProcessPriorityCodes
    http://hl7.org/fhir/ValueSet/process-priority
    from the FHIR Standard
    Claim.payee.typeexampleClaim Payee Type Codes
    http://hl7.org/fhir/ValueSet/payeetype
    from the FHIR Standard
    Claim.careTeam.rolerequiredPCTCareTeamRoleVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTCareTeamRoleVS
    from this IG
    Claim.careTeam.qualificationrequiredUSCoreProviderRoleNucc
    http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role
    Claim.careTeam:rendering.rolerequiredPattern: rendering
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTCareTeamRoleVS
    from this IG
    Claim.careTeam:rendering.qualificationrequiredUSCoreProviderRoleNucc
    http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role
    Claim.careTeam:referring.rolerequiredPattern: referring
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTCareTeamRoleVS
    from this IG
    Claim.supportingInfo.categoryextensiblePCTSupportingInfoTypeVS (a valid code from PCT GFE Supporting Info Type Code System)
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTSupportingInfoTypeVS
    from this IG
    Claim.supportingInfo:serviceFacility.categoryextensiblePattern: servicefacility
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTSupportingInfoTypeVS
    from this IG
    Claim.supportingInfo:claimFrequency.categoryextensiblePattern: claimFrequency
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTSupportingInfoTypeVS
    from this IG
    Claim.supportingInfo:claimFrequency.coderequiredPCTGFEFrequencyVS (a valid code from PCT GFE Frequency Code System)
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFEFrequencyVS
    from this IG
    Claim.diagnosis.diagnosis[x]exampleICD-10Codes
    http://hl7.org/fhir/ValueSet/icd-10
    from the FHIR Standard
    Claim.diagnosis.typerequiredPCTDiagnosisTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosisTypeVS
    from this IG
    Claim.diagnosis:principal.diagnosis[x]requiredPCTDiagnosticCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosticCodes
    from this IG
    Claim.diagnosis:principal.typerequiredPattern: principal
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosisTypeVS
    from this IG
    Claim.diagnosis:other.diagnosis[x]requiredPCTDiagnosticCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosticCodes
    from this IG
    Claim.diagnosis:other.typerequiredPattern: other
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosisTypeVS
    from this IG
    Claim.procedure.typerequiredPCTProcedureTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureTypeVS
    from this IG
    Claim.procedure.procedure[x]exampleICD-10ProcedureCodes
    http://hl7.org/fhir/ValueSet/icd-10-procedures
    from the FHIR Standard
    Claim.procedure:anesthesiaRelated.typerequiredPattern: procedureRequiringAnesthesia
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureTypeVS
    from this IG
    Claim.procedure:anesthesiaRelated.procedure[x]requiredPCTProcedureSurgicalCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureSurgicalCodes
    from this IG
    Claim.procedure:other.typerequiredPCTProcedureTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureTypeVS
    from this IG
    Claim.procedure:other.procedure[x]exampleICD-10ProcedureCodes
    http://hl7.org/fhir/ValueSet/icd-10-procedures
    from the FHIR Standard
    Claim.item.productOrServicerequiredUSClaimMedicalProductOrServiceCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/USClaimMedicalProductOrServiceCodes
    from this IG
    Claim.item.modifierrequiredPCTGFEItemCptHcpcsVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFEItemCptHcpcsVS
    from this IG
    Claim.item.location[x]requiredPCTGFECMSPOS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFECMSPOS
    from this IG
    Claim.item.detail.productOrServicerequiredUSClaimMedicalProductOrServiceCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/USClaimMedicalProductOrServiceCodes
    from this IG

    Differential View

    This structure is derived from Claim

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Claim Claim
    ... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    .... gfeServiceLinkingInfo S 0..1 (Complex) GFE Service Linking Information
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
    .... providerEventMethodology S 0..1 string Provider event collection methodology
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerEventMethodology
    .... gfeDisclaimer S 0..* string Disclaimers the patient should be made aware of regarding the providers estimate
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeDisclaimer
    ... Slices for identifier 1..* Identifier Business Identifier for claim
    Slice: Unordered, Open by value:type
    .... identifier:PLAC 1..1 Identifier Provider Assigned Identifier for GFE Claim
    ..... type 1..1 CodeableConcept Description of identifier
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: PLAC
    ....... display 1..1 string Representation defined by the system
    Fixed Value: Placer Identifier
    ..... system S 0..1 uri The namespace for the identifier value
    ..... value 1..1 string The value that is unique
    .... identifier:INTER 0..* Identifier Intermediary System Identifier
    ..... type 1..1 CodeableConcept Description of identifier
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTIdentifierType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: INTER
    ....... display 1..1 string Representation defined by the system
    Fixed Value: Intermediary System Identifier
    ... type 1..1 CodeableConcept Category or discipline
    Required Pattern: At least the following
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: professional
    ... use 1..1 code claim | preauthorization | predetermination
    Required Pattern: predetermination
    ... patient 1..1 Reference(HRex Patient Demographics) The recipient of the products and services
    ... insurer S 0..1 Reference(PCT Organization) Required if insured estimate
    ... provider 1..1 Reference(PCT Organization | PCT Practitioner) Billing provider - party responsible for the GFE
    .... extension 1..* Extension Extension
    .... Slices for extension Content/Rules for all slices
    ..... providerTaxonomy 1..1 CodeableConcept Provider taxonomy codes consisting of NUCC Health Care Provider Taxonomy Code Set for providers
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerTaxonomy
    Binding: US Core Provider Role (NUCC) (extensible)
    ..... consentForBalanceBilling S 0..1 boolean Extension
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeConsentForBalanceBilling
    ... priority 1..1 CodeableConcept Desired processing ugency
    Binding: ProcessPriorityCodes (required)
    ... payee S 0..1 BackboneElement Recipient of benefits payable
    .... party 0..1 Reference(PCT Practitioner | PCT Organization) Recipient reference
    ... referral
    .... extension 1..* Extension Extension
    .... Slices for extension Content/Rules for all slices
    ..... referralNumber 1..1 string Referral Number
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/referralNumber
    ... Slices for careTeam S 0..* BackboneElement Members of the care team
    Slice: Unordered, Open by value:role
    .... careTeam:All Slices Content/Rules for all slices
    ..... provider 1..1 Reference(PCT Practitioner | PCT Organization) Practitioner or organization
    ..... role 1..1 CodeableConcept Function within the team
    Binding: PCT Care Team Role Value Set (required)
    ..... qualification 0..1 CodeableConcept Practitioner credential or specialization
    Binding: US Core Provider Role (NUCC) (required)
    .... careTeam:rendering 0..* BackboneElement Members of the care team
    ..... role 1..1 CodeableConcept Function within the team
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTCareTeamRole
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: rendering
    ..... qualification 1..1 CodeableConcept Practitioner credential or specialization - must provide a taxonomy code for the Professional case
    .... careTeam:referring 0..1 BackboneElement Members of the care team
    ..... role 1..1 CodeableConcept Function within the team
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTCareTeamRole
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: referring
    ... Slices for supportingInfo S 0..* BackboneElement Supporting information
    Slice: Unordered, Open by value:category
    .... supportingInfo:All Slices Content/Rules for all slices
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Binding: PCT Supporting Info Type Value Set (extensible)
    .... supportingInfo:serviceFacility S 0..1 BackboneElement Service Facility
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTSupportingInfoType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: servicefacility
    ..... Slices for value[x] 1..1 Reference(Resource) Data to be provided
    Slice: Unordered, Open by type:$this
    ...... value[x]:valueReference 1..1 Reference(PCT Organization) Data to be provided
    .... supportingInfo:claimFrequency S 0..1 BackboneElement Claim Frequency
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTSupportingInfoType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: claimFrequency
    ..... code 1..1 CodeableConcept Type of information
    Binding: PCT GFE Frequency Code Value Set (required)
    ... Slices for diagnosis S 0..* BackboneElement Pertinent diagnosis information
    Slice: Unordered, Open by value:type
    .... diagnosis:All Slices Content/Rules for all slices
    ..... type S 0..* CodeableConcept Timing or nature of the diagnosis
    Binding: PCT Diagnosis Type Value Set (required)
    .... diagnosis:principal S 0..1 BackboneElement Principal Diagnosis - Must Support means the information source SHALL be capable of populating and SHALL populate if available and permitted.
    ..... sequence 1..1 positiveInt Diagnosis instance identifier
    Required Pattern: 1
    ..... diagnosis[x] 1..1 CodeableConcept Nature of illness or problem
    Binding: PCT ICD-10 Diagnostic Codes (required)
    ..... type 1..1 CodeableConcept Timing or nature of the diagnosis
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/ex-diagnosistype
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: principal
    .... diagnosis:other S 0..11 BackboneElement Pertinent diagnosis information
    ..... diagnosis[x] 1..1 CodeableConcept Nature of illness or problem
    Binding: PCT ICD-10 Diagnostic Codes (required)
    ..... type 1..1 CodeableConcept Timing or nature of the diagnosis
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDiagnosisType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: other
    ... Slices for procedure S 0..* BackboneElement Clinical procedures performed
    Slice: Unordered, Open by value:type
    .... procedure:All Slices Content/Rules for all slices
    ..... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ..... type S 0..* CodeableConcept Category of Procedure
    Binding: PCT Procedure Type Value Set (required)
    .... procedure:anesthesiaRelated S 0..2 BackboneElement Clinical procedures performed
    ..... Slices for extension Content/Rules for all slices
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ..... type 1..1 CodeableConcept Category of Procedure
    Required Pattern: At least the following
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTProcedureType
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: procedureRequiringAnesthesia
    ..... procedure[x] 1..1 CodeableConcept Specific clinical procedure
    Binding: PCT CMS HCPCS and AMA CPT Procedure Surgical Codes (required)
    .... procedure:other S 0..24 BackboneElement Clinical procedures performed
    ... insurance
    .... coverage 1..1 Reference(PCT Coverage) Insurance information
    ..... Slices for extension Content/Rules for all slices
    ...... dataAbsentReason S 0..1 code Coverage may be not applicable if estimate is for self-pay or uninsured
    URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
    Binding: DataAbsentReason (required)
    .... preAuthRef 0..2 string Prior authorization reference number
    ... accident
    .... location[x] 0..1 Address Where the event occurred
    ..... country 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
    Binding: Iso3166-1-2 (required)
    ... item 1..50 BackboneElement Product or service provided
    .... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ..... referralNumber S 0..11 string Referral Number
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/referralNumber
    ..... gfeBillingProviderLineItemCtrlNum S 0..1 Identifier Extension
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeBillingProviderLineItemCtrlNum
    ..... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ..... ProviderEventMethodology S 0..1 string Provider Event Methodology
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerEventMethodology
    .... careTeamSequence S 0..* positiveInt Applicable careTeam members
    .... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
    Binding: Claim Medical Product or Service Value Set (required)
    .... modifier S 0..4 CodeableConcept Product or service billing modifiers
    Binding: PCT GFE Item CPT - HCPCS Value Set (required)
    .... serviced[x] S 1..1 date, Period This is the planned or estimated date(s)s of service
    .... location[x] 1..1 CodeableConcept Place of service or where product was supplied
    Binding: PCT GFE CMS Place of Service Value Set (required)
    .... quantity 1..1 SimpleQuantity Count of products or services
    .... unitPrice 1..1 Money Fee, charge or cost per item
    .... net 1..1 Money Total charge amount for the service line
    .... detail S 0..* BackboneElement Drug Identification Information
    ..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
    Binding: Claim Medical Product or Service Value Set (required)
    ..... quantity S 0..1 SimpleQuantity Count of products or services
    ... total 1..1 Money Total GFE Charges Submitted

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Claim.priorityrequiredProcessPriorityCodes
    http://hl7.org/fhir/ValueSet/process-priority
    from the FHIR Standard
    Claim.careTeam.rolerequiredPCTCareTeamRoleVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTCareTeamRoleVS
    from this IG
    Claim.careTeam.qualificationrequiredUSCoreProviderRoleNucc
    http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role
    Claim.supportingInfo.categoryextensiblePCTSupportingInfoTypeVS (a valid code from PCT GFE Supporting Info Type Code System)
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTSupportingInfoTypeVS
    from this IG
    Claim.supportingInfo:claimFrequency.coderequiredPCTGFEFrequencyVS (a valid code from PCT GFE Frequency Code System)
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFEFrequencyVS
    from this IG
    Claim.diagnosis.typerequiredPCTDiagnosisTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosisTypeVS
    from this IG
    Claim.diagnosis:principal.diagnosis[x]requiredPCTDiagnosticCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosticCodes
    from this IG
    Claim.diagnosis:other.diagnosis[x]requiredPCTDiagnosticCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosticCodes
    from this IG
    Claim.procedure.typerequiredPCTProcedureTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureTypeVS
    from this IG
    Claim.procedure:anesthesiaRelated.procedure[x]requiredPCTProcedureSurgicalCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureSurgicalCodes
    from this IG
    Claim.accident.location[x].countryrequiredIso3166-1-2
    http://hl7.org/fhir/ValueSet/iso3166-1-2
    from the FHIR Standard
    Claim.item.productOrServicerequiredUSClaimMedicalProductOrServiceCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/USClaimMedicalProductOrServiceCodes
    from this IG
    Claim.item.modifierrequiredPCTGFEItemCptHcpcsVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFEItemCptHcpcsVS
    from this IG
    Claim.item.location[x]requiredPCTGFECMSPOS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFECMSPOS
    from this IG
    Claim.item.detail.productOrServicerequiredUSClaimMedicalProductOrServiceCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/USClaimMedicalProductOrServiceCodes
    from this IG

    Snapshot View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Claim 0..* Claim Claim, Pre-determination or Pre-authorization
    ... id Σ 0..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    ... contained 0..* Resource Contained, inline Resources
    ... Slices for extension 0..* Extension Extension
    Slice: Unordered, Open by value:url
    .... gfeServiceLinkingInfo S 0..1 (Complex) GFE Service Linking Information
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
    .... providerEventMethodology S 0..1 string Provider event collection methodology
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerEventMethodology
    .... gfeDisclaimer S 0..* string Disclaimers the patient should be made aware of regarding the providers estimate
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeDisclaimer
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... Slices for identifier 1..* Identifier Business Identifier for claim
    Slice: Unordered, Open by value:type
    .... identifier:PLAC 1..1 Identifier Provider Assigned Identifier for GFE Claim
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
    Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

    ..... type Σ 1..1 CodeableConcept Description of identifier
    Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: PLAC
    ....... display 1..1 string Representation defined by the system
    Fixed Value: Placer Identifier
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... system SΣ 0..1 uri The namespace for the identifier value
    Example General: http://www.acme.com/identifiers/patient
    ..... value Σ 1..1 string The value that is unique
    Example General: 123456
    ..... period Σ 0..1 Period Time period when id is/was valid for use
    ..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
    .... identifier:INTER 0..* Identifier Intermediary System Identifier
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
    Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

    ..... type Σ 1..1 CodeableConcept Description of identifier
    Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.


    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTIdentifierType
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: INTER
    ....... display 1..1 string Representation defined by the system
    Fixed Value: Intermediary System Identifier
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... system Σ 0..1 uri The namespace for the identifier value
    Example General: http://www.acme.com/identifiers/patient
    ..... value Σ 0..1 string The value that is unique
    Example General: 123456
    ..... period Σ 0..1 Period Time period when id is/was valid for use
    ..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
    ... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
    Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.

    ... type Σ 1..1 CodeableConcept Category or discipline
    Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.


    Required Pattern: At least the following
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
    ..... version 0..1 string Version of the system - if relevant
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: professional
    ..... display 0..1 string Representation defined by the system
    ..... userSelected 0..1 boolean If this coding was chosen directly by the user
    .... text 0..1 string Plain text representation of the concept
    ... subType 0..1 CodeableConcept More granular claim type
    Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode.

    ... use Σ 1..1 code claim | preauthorization | predetermination
    Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.


    Required Pattern: predetermination
    ... patient Σ 1..1 Reference(HRex Patient Demographics) The recipient of the products and services
    ... billablePeriod Σ 0..1 Period Relevant time frame for the claim
    ... created Σ 1..1 dateTime Resource creation date
    ... enterer 0..1 Reference(Practitioner | PractitionerRole) Author of the claim
    ... insurer SΣ 0..1 Reference(PCT Organization) Required if insured estimate
    ... provider Σ 1..1 Reference(PCT Organization | PCT Practitioner) Billing provider - party responsible for the GFE
    .... id 0..1 string Unique id for inter-element referencing
    .... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ..... providerTaxonomy 1..1 CodeableConcept Provider taxonomy codes consisting of NUCC Health Care Provider Taxonomy Code Set for providers
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerTaxonomy
    Binding: US Core Provider Role (NUCC) (extensible)
    ..... consentForBalanceBilling S 0..1 boolean Extension
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeConsentForBalanceBilling
    .... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
    .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... priority Σ 1..1 CodeableConcept Desired processing ugency
    Binding: ProcessPriorityCodes (required)
    ... fundsReserve 0..1 CodeableConcept For whom to reserve funds
    Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).

    ... related 0..* BackboneElement Prior or corollary claims
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... claim 0..1 Reference(Claim) Reference to the related claim
    .... relationship 0..1 CodeableConcept How the reference claim is related
    Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.

    .... reference 0..1 Identifier File or case reference
    ... prescription 0..1 Reference(DeviceRequest | MedicationRequest | VisionPrescription) Prescription authorizing services and products
    ... originalPrescription 0..1 Reference(DeviceRequest | MedicationRequest | VisionPrescription) Original prescription if superseded by fulfiller
    ... payee S 0..1 BackboneElement Recipient of benefits payable
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... type 1..1 CodeableConcept Category of recipient
    Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.

    .... party 0..1 Reference(PCT Practitioner | PCT Organization) Recipient reference
    ... referral 0..1 Reference(ServiceRequest) Treatment referral
    .... id 0..1 string Unique id for inter-element referencing
    .... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ..... referralNumber 1..1 string Referral Number
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/referralNumber
    .... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
    .... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

    .... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    .... display Σ 0..1 string Text alternative for the resource
    ... facility 0..1 Reference(Location) Servicing facility
    ... Slices for careTeam S 0..* BackboneElement Members of the care team
    Slice: Unordered, Open by value:role
    .... careTeam:All Slices Content/Rules for all slices
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Order of care team
    ..... provider 1..1 Reference(PCT Practitioner | PCT Organization) Practitioner or organization
    ..... responsible 0..1 boolean Indicator of the lead practitioner
    ..... role 1..1 CodeableConcept Function within the team
    Binding: PCT Care Team Role Value Set (required)
    ..... qualification 0..1 CodeableConcept Practitioner credential or specialization
    Binding: US Core Provider Role (NUCC) (required)
    .... careTeam:rendering 0..* BackboneElement Members of the care team
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Order of care team
    ..... provider 1..1 Reference(PCT Practitioner | PCT Organization) Practitioner or organization
    ..... responsible 0..1 boolean Indicator of the lead practitioner
    ..... role 1..1 CodeableConcept Function within the team
    Binding: PCT Care Team Role Value Set (required)
    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTCareTeamRole
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: rendering
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... qualification 1..1 CodeableConcept Practitioner credential or specialization - must provide a taxonomy code for the Professional case
    Binding: US Core Provider Role (NUCC) (required)
    .... careTeam:referring 0..1 BackboneElement Members of the care team
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Order of care team
    ..... provider 1..1 Reference(PCT Practitioner | PCT Organization) Practitioner or organization
    ..... responsible 0..1 boolean Indicator of the lead practitioner
    ..... role 1..1 CodeableConcept Function within the team
    Binding: PCT Care Team Role Value Set (required)
    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTCareTeamRole
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: referring
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... qualification 0..1 CodeableConcept Practitioner credential or specialization
    Binding: US Core Provider Role (NUCC) (required)
    ... Slices for supportingInfo S 0..* BackboneElement Supporting information
    Slice: Unordered, Open by value:category
    .... supportingInfo:All Slices Content/Rules for all slices
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Information instance identifier
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Binding: PCT Supporting Info Type Value Set (extensible)
    ..... code 0..1 CodeableConcept Type of information
    Binding: ExceptionCodes (example): The valuset used for additional information codes.

    ..... timing[x] 0..1 When it occurred
    ...... timingDate date
    ...... timingPeriod Period
    ..... value[x] 0..1 Data to be provided
    ...... valueBoolean boolean
    ...... valueString string
    ...... valueQuantity Quantity
    ...... valueAttachment Attachment
    ...... valueReference Reference(Resource)
    ..... reason 0..1 CodeableConcept Explanation for the information
    Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

    .... supportingInfo:serviceFacility S 0..1 BackboneElement Service Facility
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Information instance identifier
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Binding: PCT Supporting Info Type Value Set (extensible)
    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTSupportingInfoType
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: servicefacility
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... code 0..1 CodeableConcept Type of information
    Binding: ExceptionCodes (example): The valuset used for additional information codes.

    ..... timing[x] 0..1 When it occurred
    ...... timingDate date
    ...... timingPeriod Period
    ..... Slices for value[x] 1..1 Reference(Resource) Data to be provided
    Slice: Unordered, Closed by type:$this
    ...... value[x]:valueReference 1..1 Reference(PCT Organization) Data to be provided
    ..... reason 0..1 CodeableConcept Explanation for the information
    Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

    .... supportingInfo:claimFrequency S 0..1 BackboneElement Claim Frequency
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Information instance identifier
    ..... category 1..1 CodeableConcept Classification of the supplied information
    Binding: PCT Supporting Info Type Value Set (extensible)
    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTSupportingInfoType
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: claimFrequency
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... code 1..1 CodeableConcept Type of information
    Binding: PCT GFE Frequency Code Value Set (required)
    ..... timing[x] 0..1 When it occurred
    ...... timingDate date
    ...... timingPeriod Period
    ..... value[x] 0..1 Data to be provided
    ...... valueBoolean boolean
    ...... valueString string
    ...... valueQuantity Quantity
    ...... valueAttachment Attachment
    ...... valueReference Reference(Resource)
    ..... reason 0..1 CodeableConcept Explanation for the information
    Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

    ... Slices for diagnosis S 0..* BackboneElement Pertinent diagnosis information
    Slice: Unordered, Open by value:type
    .... diagnosis:All Slices Content/Rules for all slices
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Diagnosis instance identifier
    ..... diagnosis[x] 1..1 Nature of illness or problem
    Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.

    ...... diagnosisCodeableConcept CodeableConcept
    ...... diagnosisReference Reference(Condition)
    ..... type S 0..* CodeableConcept Timing or nature of the diagnosis
    Binding: PCT Diagnosis Type Value Set (required)
    ..... onAdmission 0..1 CodeableConcept Present on admission
    Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.

    ..... packageCode 0..1 CodeableConcept Package billing code
    Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.

    .... diagnosis:principal S 0..1 BackboneElement Principal Diagnosis - Must Support means the information source SHALL be capable of populating and SHALL populate if available and permitted.
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Diagnosis instance identifier
    Required Pattern: 1
    ..... diagnosis[x] 1..1 CodeableConcept Nature of illness or problem
    Binding: PCT ICD-10 Diagnostic Codes (required)
    ..... type S 1..1 CodeableConcept Timing or nature of the diagnosis
    Binding: PCT Diagnosis Type Value Set (required)

    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://terminology.hl7.org/CodeSystem/ex-diagnosistype
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: principal
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... onAdmission 0..1 CodeableConcept Present on admission
    Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.

    ..... packageCode 0..1 CodeableConcept Package billing code
    Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.

    .... diagnosis:other S 0..11 BackboneElement Pertinent diagnosis information
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Diagnosis instance identifier
    ..... diagnosis[x] 1..1 CodeableConcept Nature of illness or problem
    Binding: PCT ICD-10 Diagnostic Codes (required)
    ..... type S 1..1 CodeableConcept Timing or nature of the diagnosis
    Binding: PCT Diagnosis Type Value Set (required)

    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDiagnosisType
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: other
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... onAdmission 0..1 CodeableConcept Present on admission
    Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.

    ..... packageCode 0..1 CodeableConcept Package billing code
    Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.

    ... Slices for procedure S 0..* BackboneElement Clinical procedures performed
    Slice: Unordered, Open by value:type
    .... procedure:All Slices Content/Rules for all slices
    ..... id 0..1 string Unique id for inter-element referencing
    ..... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Procedure instance identifier
    ..... type S 0..* CodeableConcept Category of Procedure
    Binding: PCT Procedure Type Value Set (required)
    ..... date 0..1 dateTime When the procedure was performed
    ..... procedure[x] 1..1 Specific clinical procedure
    Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.

    ...... procedureCodeableConcept CodeableConcept
    ...... procedureReference Reference(Procedure)
    ..... udi 0..* Reference(Device) Unique device identifier
    .... procedure:anesthesiaRelated S 0..2 BackboneElement Clinical procedures performed
    ..... id 0..1 string Unique id for inter-element referencing
    ..... Slices for extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Procedure instance identifier
    ..... type S 1..1 CodeableConcept Category of Procedure
    Binding: PCT Procedure Type Value Set (required)

    Required Pattern: At least the following
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ....... id 0..1 string Unique id for inter-element referencing
    ....... extension 0..* Extension Additional content defined by implementations
    ....... system 1..1 uri Identity of the terminology system
    Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTProcedureType
    ....... version 0..1 string Version of the system - if relevant
    ....... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: procedureRequiringAnesthesia
    ....... display 0..1 string Representation defined by the system
    ....... userSelected 0..1 boolean If this coding was chosen directly by the user
    ...... text 0..1 string Plain text representation of the concept
    ..... date 0..1 dateTime When the procedure was performed
    ..... procedure[x] 1..1 CodeableConcept Specific clinical procedure
    Binding: PCT CMS HCPCS and AMA CPT Procedure Surgical Codes (required)
    ..... udi 0..* Reference(Device) Unique device identifier
    .... procedure:other S 0..24 BackboneElement Clinical procedures performed
    ..... id 0..1 string Unique id for inter-element referencing
    ..... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ...... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Procedure instance identifier
    ..... type S 0..* CodeableConcept Category of Procedure
    Binding: PCT Procedure Type Value Set (required)
    ..... date 0..1 dateTime When the procedure was performed
    ..... procedure[x] 1..1 Specific clinical procedure
    Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.

    ...... procedureCodeableConcept CodeableConcept
    ...... procedureReference Reference(Procedure)
    ..... udi 0..* Reference(Device) Unique device identifier
    ... insurance Σ 1..* BackboneElement Patient insurance information
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... sequence Σ 1..1 positiveInt Insurance instance identifier
    .... focal Σ 1..1 boolean Coverage to be used for adjudication
    .... identifier 0..1 Identifier Pre-assigned Claim number
    .... coverage Σ 1..1 Reference(PCT Coverage) Insurance information
    ..... id 0..1 string Unique id for inter-element referencing
    ..... Slices for extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ...... dataAbsentReason S 0..1 code Coverage may be not applicable if estimate is for self-pay or uninsured
    URL: http://hl7.org/fhir/StructureDefinition/data-absent-reason
    Binding: DataAbsentReason (required)
    ..... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
    ..... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
    Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

    ..... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
    ..... display Σ 0..1 string Text alternative for the resource
    .... businessArrangement 0..1 string Additional provider contract number
    .... preAuthRef 0..2 string Prior authorization reference number
    .... claimResponse 0..1 Reference(ClaimResponse) Adjudication results
    ... accident 0..1 BackboneElement Details of the event
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... date 1..1 date When the incident occurred
    .... type 0..1 CodeableConcept The nature of the accident
    Binding: ActIncidentCode (extensible): Type of accident: work place, auto, etc.

    .... location[x] 0..1 Address Where the event occurred
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    Slice: Unordered, Open by value:url
    ..... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
    Binding: AddressUse (required): The use of an address.


    Example General: home
    ..... type Σ 0..1 code postal | physical | both
    Binding: AddressType (required): The type of an address (physical / postal).


    Example General: both
    ..... text Σ 0..1 string Text representation of the address
    Example General: 137 Nowhere Street, Erewhon 9132
    ..... line Σ 0..* string Street name, number, direction & P.O. Box etc.
    This repeating element order: The order in which lines should appear in an address label
    Example General: 137 Nowhere Street
    ..... city Σ 0..1 string Name of city, town etc.
    Example General: Erewhon
    ..... district Σ 0..1 string District name (aka county)
    Example General: Madison
    ..... state Σ 0..1 string Sub-unit of country (abbreviations ok)
    ..... postalCode Σ 0..1 string Postal code for area
    Example General: 9132
    ..... country Σ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
    Binding: Iso3166-1-2 (required)
    ..... period Σ 0..1 Period Time period when address was/is in use
    Example General: {"start":"2010-03-23","end":"2010-07-01"}
    ... item 1..50 BackboneElement Product or service provided
    .... id 0..1 string Unique id for inter-element referencing
    .... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ..... referralNumber S 0..11 string Referral Number
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/referralNumber
    ..... gfeBillingProviderLineItemCtrlNum S 0..1 Identifier Extension
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeBillingProviderLineItemCtrlNum
    ..... serviceDescription 1..1 string Service Description
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/serviceDescription
    ..... ProviderEventMethodology S 0..1 string Provider Event Methodology
    URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/providerEventMethodology
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... sequence 1..1 positiveInt Item instance identifier
    .... careTeamSequence S 0..* positiveInt Applicable careTeam members
    .... diagnosisSequence 0..* positiveInt Applicable diagnoses
    .... procedureSequence 0..* positiveInt Applicable procedures
    .... informationSequence 0..* positiveInt Applicable exception and supporting information
    .... revenue 0..1 CodeableConcept Revenue or cost center code
    Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

    .... category 0..1 CodeableConcept Benefit classification
    Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

    .... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
    Binding: Claim Medical Product or Service Value Set (required)
    .... modifier S 0..4 CodeableConcept Product or service billing modifiers
    Binding: PCT GFE Item CPT - HCPCS Value Set (required)
    .... programCode 0..* CodeableConcept Program the product or service is provided under
    Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


    .... serviced[x] S 1..1 This is the planned or estimated date(s)s of service
    ..... servicedDate date
    ..... servicedPeriod Period
    .... location[x] 1..1 CodeableConcept Place of service or where product was supplied
    Binding: PCT GFE CMS Place of Service Value Set (required)
    .... quantity 1..1 SimpleQuantity Count of products or services
    .... unitPrice 1..1 Money Fee, charge or cost per item
    .... factor 0..1 decimal Price scaling factor
    .... net 1..1 Money Total charge amount for the service line
    .... udi 0..* Reference(Device) Unique device identifier
    .... bodySite 0..1 CodeableConcept Anatomical location
    Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.

    .... subSite 0..* CodeableConcept Anatomical sub-location
    Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.


    .... encounter 0..* Reference(Encounter) Encounters related to this billed item
    .... detail S 0..* BackboneElement Drug Identification Information
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ..... sequence 1..1 positiveInt Item instance identifier
    ..... revenue 0..1 CodeableConcept Revenue or cost center code
    Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

    ..... category 0..1 CodeableConcept Benefit classification
    Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

    ..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
    Binding: Claim Medical Product or Service Value Set (required)
    ..... modifier 0..* CodeableConcept Service/Product billing modifiers
    Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


    ..... programCode 0..* CodeableConcept Program the product or service is provided under
    Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


    ..... quantity S 0..1 SimpleQuantity Count of products or services
    ..... unitPrice 0..1 Money Fee, charge or cost per item
    ..... factor 0..1 decimal Price scaling factor
    ..... net 0..1 Money Total item cost
    ..... udi 0..* Reference(Device) Unique device identifier
    ..... subDetail 0..* BackboneElement Product or service provided
    ...... id 0..1 string Unique id for inter-element referencing
    ...... extension 0..* Extension Additional content defined by implementations
    ...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ...... sequence 1..1 positiveInt Item instance identifier
    ...... revenue 0..1 CodeableConcept Revenue or cost center code
    Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

    ...... category 0..1 CodeableConcept Benefit classification
    Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

    ...... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
    Binding: USCLSCodes (example): Allowable service and product codes.

    ...... modifier 0..* CodeableConcept Service/Product billing modifiers
    Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


    ...... programCode 0..* CodeableConcept Program the product or service is provided under
    Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


    ...... quantity 0..1 SimpleQuantity Count of products or services
    ...... unitPrice 0..1 Money Fee, charge or cost per item
    ...... factor 0..1 decimal Price scaling factor
    ...... net 0..1 Money Total item cost
    ...... udi 0..* Reference(Device) Unique device identifier
    ... total 1..1 Money Total GFE Charges Submitted

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Claim.languagepreferredCommonLanguages
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Additional Bindings Purpose
    AllLanguages Max Binding
    Claim.identifier:PLAC.userequiredIdentifierUse
    http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
    from the FHIR Standard
    Claim.identifier:PLAC.typeextensiblePattern: PLAC("Placer Identifier")
    http://hl7.org/fhir/ValueSet/identifier-type
    from the FHIR Standard
    Claim.identifier:INTER.userequiredIdentifierUse
    http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
    from the FHIR Standard
    Claim.identifier:INTER.typeextensiblePattern: INTER("Intermediary System Identifier")
    http://hl7.org/fhir/ValueSet/identifier-type
    from the FHIR Standard
    Claim.statusrequiredFinancialResourceStatusCodes
    http://hl7.org/fhir/ValueSet/fm-status|4.0.1
    from the FHIR Standard
    Claim.typeextensiblePattern: professional
    http://hl7.org/fhir/ValueSet/claim-type
    from the FHIR Standard
    Claim.subTypeexampleExampleClaimSubTypeCodes
    http://hl7.org/fhir/ValueSet/claim-subtype
    from the FHIR Standard
    Claim.userequiredPattern: predetermination
    http://hl7.org/fhir/ValueSet/claim-use|4.0.1
    from the FHIR Standard
    Claim.provider.typeextensibleResourceType
    http://hl7.org/fhir/ValueSet/resource-types
    from the FHIR Standard
    Claim.priorityrequiredProcessPriorityCodes
    http://hl7.org/fhir/ValueSet/process-priority
    from the FHIR Standard
    Claim.fundsReserveexampleFunds Reservation Codes
    http://hl7.org/fhir/ValueSet/fundsreserve
    from the FHIR Standard
    Claim.related.relationshipexampleExampleRelatedClaimRelationshipCodes
    http://hl7.org/fhir/ValueSet/related-claim-relationship
    from the FHIR Standard
    Claim.payee.typeexampleClaim Payee Type Codes
    http://hl7.org/fhir/ValueSet/payeetype
    from the FHIR Standard
    Claim.referral.typeextensibleResourceType
    http://hl7.org/fhir/ValueSet/resource-types
    from the FHIR Standard
    Claim.careTeam.rolerequiredPCTCareTeamRoleVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTCareTeamRoleVS
    from this IG
    Claim.careTeam.qualificationrequiredUSCoreProviderRoleNucc
    http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role
    Claim.careTeam:rendering.rolerequiredPattern: rendering
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTCareTeamRoleVS
    from this IG
    Claim.careTeam:rendering.qualificationrequiredUSCoreProviderRoleNucc
    http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role
    Claim.careTeam:referring.rolerequiredPattern: referring
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTCareTeamRoleVS
    from this IG
    Claim.careTeam:referring.qualificationrequiredUSCoreProviderRoleNucc
    http://hl7.org/fhir/us/core/ValueSet/us-core-provider-role
    Claim.supportingInfo.categoryextensiblePCTSupportingInfoTypeVS (a valid code from PCT GFE Supporting Info Type Code System)
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTSupportingInfoTypeVS
    from this IG
    Claim.supportingInfo.codeexampleExceptionCodes
    http://hl7.org/fhir/ValueSet/claim-exception
    from the FHIR Standard
    Claim.supportingInfo.reasonexampleMissingToothReasonCodes
    http://hl7.org/fhir/ValueSet/missing-tooth-reason
    from the FHIR Standard
    Claim.supportingInfo:serviceFacility.categoryextensiblePattern: servicefacility
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTSupportingInfoTypeVS
    from this IG
    Claim.supportingInfo:serviceFacility.codeexampleExceptionCodes
    http://hl7.org/fhir/ValueSet/claim-exception
    from the FHIR Standard
    Claim.supportingInfo:serviceFacility.reasonexampleMissingToothReasonCodes
    http://hl7.org/fhir/ValueSet/missing-tooth-reason
    from the FHIR Standard
    Claim.supportingInfo:claimFrequency.categoryextensiblePattern: claimFrequency
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTSupportingInfoTypeVS
    from this IG
    Claim.supportingInfo:claimFrequency.coderequiredPCTGFEFrequencyVS (a valid code from PCT GFE Frequency Code System)
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFEFrequencyVS
    from this IG
    Claim.supportingInfo:claimFrequency.reasonexampleMissingToothReasonCodes
    http://hl7.org/fhir/ValueSet/missing-tooth-reason
    from the FHIR Standard
    Claim.diagnosis.diagnosis[x]exampleICD-10Codes
    http://hl7.org/fhir/ValueSet/icd-10
    from the FHIR Standard
    Claim.diagnosis.typerequiredPCTDiagnosisTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosisTypeVS
    from this IG
    Claim.diagnosis.onAdmissionexampleExampleDiagnosisOnAdmissionCodes
    http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission
    from the FHIR Standard
    Claim.diagnosis.packageCodeexampleExampleDiagnosisRelatedGroupCodes
    http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup
    from the FHIR Standard
    Claim.diagnosis:principal.diagnosis[x]requiredPCTDiagnosticCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosticCodes
    from this IG
    Claim.diagnosis:principal.typerequiredPattern: principal
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosisTypeVS
    from this IG
    Claim.diagnosis:principal.onAdmissionexampleExampleDiagnosisOnAdmissionCodes
    http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission
    from the FHIR Standard
    Claim.diagnosis:principal.packageCodeexampleExampleDiagnosisRelatedGroupCodes
    http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup
    from the FHIR Standard
    Claim.diagnosis:other.diagnosis[x]requiredPCTDiagnosticCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosticCodes
    from this IG
    Claim.diagnosis:other.typerequiredPattern: other
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTDiagnosisTypeVS
    from this IG
    Claim.diagnosis:other.onAdmissionexampleExampleDiagnosisOnAdmissionCodes
    http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission
    from the FHIR Standard
    Claim.diagnosis:other.packageCodeexampleExampleDiagnosisRelatedGroupCodes
    http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup
    from the FHIR Standard
    Claim.procedure.typerequiredPCTProcedureTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureTypeVS
    from this IG
    Claim.procedure.procedure[x]exampleICD-10ProcedureCodes
    http://hl7.org/fhir/ValueSet/icd-10-procedures
    from the FHIR Standard
    Claim.procedure:anesthesiaRelated.typerequiredPattern: procedureRequiringAnesthesia
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureTypeVS
    from this IG
    Claim.procedure:anesthesiaRelated.procedure[x]requiredPCTProcedureSurgicalCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureSurgicalCodes
    from this IG
    Claim.procedure:other.typerequiredPCTProcedureTypeVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTProcedureTypeVS
    from this IG
    Claim.procedure:other.procedure[x]exampleICD-10ProcedureCodes
    http://hl7.org/fhir/ValueSet/icd-10-procedures
    from the FHIR Standard
    Claim.insurance.coverage.typeextensibleResourceType
    http://hl7.org/fhir/ValueSet/resource-types
    from the FHIR Standard
    Claim.accident.typeextensibleActIncidentCode
    http://terminology.hl7.org/ValueSet/v3-ActIncidentCode
    Claim.accident.location[x].userequiredAddressUse
    http://hl7.org/fhir/ValueSet/address-use|4.0.1
    from the FHIR Standard
    Claim.accident.location[x].typerequiredAddressType
    http://hl7.org/fhir/ValueSet/address-type|4.0.1
    from the FHIR Standard
    Claim.accident.location[x].countryrequiredIso3166-1-2
    http://hl7.org/fhir/ValueSet/iso3166-1-2
    from the FHIR Standard
    Claim.item.revenueexampleExampleRevenueCenterCodes
    http://hl7.org/fhir/ValueSet/ex-revenue-center
    from the FHIR Standard
    Claim.item.categoryexampleBenefitCategoryCodes
    http://hl7.org/fhir/ValueSet/ex-benefitcategory
    from the FHIR Standard
    Claim.item.productOrServicerequiredUSClaimMedicalProductOrServiceCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/USClaimMedicalProductOrServiceCodes
    from this IG
    Claim.item.modifierrequiredPCTGFEItemCptHcpcsVS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFEItemCptHcpcsVS
    from this IG
    Claim.item.programCodeexampleExampleProgramReasonCodes
    http://hl7.org/fhir/ValueSet/ex-program-code
    from the FHIR Standard
    Claim.item.location[x]requiredPCTGFECMSPOS
    http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTGFECMSPOS
    from this IG
    Claim.item.bodySiteexampleOralSiteCodes
    http://hl7.org/fhir/ValueSet/tooth
    from the FHIR Standard
    Claim.item.subSiteexampleSurfaceCodes
    http://hl7.org/fhir/ValueSet/surface
    from the FHIR Standard
    Claim.item.detail.revenueexampleExampleRevenueCenterCodes
    http://hl7.org/fhir/ValueSet/ex-revenue-center
    from the FHIR Standard
    Claim.item.detail.categoryexampleBenefitCategoryCodes
    http://hl7.org/fhir/ValueSet/ex-benefitcategory
    from the FHIR Standard
    Claim.item.detail.productOrServicerequiredUSClaimMedicalProductOrServiceCodes
    http://hl7.org/fhir/us/davinci-pct/ValueSet/USClaimMedicalProductOrServiceCodes
    from this IG
    Claim.item.detail.modifierexampleModifierTypeCodes
    http://hl7.org/fhir/ValueSet/claim-modifiers
    from the FHIR Standard
    Claim.item.detail.programCodeexampleExampleProgramReasonCodes
    http://hl7.org/fhir/ValueSet/ex-program-code
    from the FHIR Standard
    Claim.item.detail.subDetail.revenueexampleExampleRevenueCenterCodes
    http://hl7.org/fhir/ValueSet/ex-revenue-center
    from the FHIR Standard
    Claim.item.detail.subDetail.categoryexampleBenefitCategoryCodes
    http://hl7.org/fhir/ValueSet/ex-benefitcategory
    from the FHIR Standard
    Claim.item.detail.subDetail.productOrServiceexampleUSCLSCodes
    http://hl7.org/fhir/ValueSet/service-uscls
    from the FHIR Standard
    Claim.item.detail.subDetail.modifierexampleModifierTypeCodes
    http://hl7.org/fhir/ValueSet/claim-modifiers
    from the FHIR Standard
    Claim.item.detail.subDetail.programCodeexampleExampleProgramReasonCodes
    http://hl7.org/fhir/ValueSet/ex-program-code
    from the FHIR Standard

    This structure is derived from Claim

    Summary

    Mandatory: 15 elements(14 nested mandatory elements)
    Must-Support: 28 elements

    Structures

    This structure refers to these other structures:

    Extensions

    This structure refers to these extensions:

    Slices

    This structure defines the following Slices:

    • The element 1 is sliced based on the value of Claim.identifier
    • The element 1 is sliced based on the value of Claim.careTeam
    • The element 1 is sliced based on the value of Claim.supportingInfo
    • The element 1 is sliced based on the value of Claim.supportingInfo.value[x]
    • The element 1 is sliced based on the value of Claim.diagnosis
    • The element 1 is sliced based on the value of Claim.procedure

    Maturity: 2

     

    Other representations of profile: CSV, Excel, Schematron