Belgian MyCareNet eAttestation Profiles
1.0.0 - STU Belgium flag

Belgian MyCareNet eAttestation Profiles, published by eHealth Platform. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/eattestation/ and changes regularly. See the Directory of published versions

Resource Profile: BeEattestationClaim - Detailed Descriptions

Draft as of 2024-03-14

Definitions for the be-eattestation-claim resource profile.

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

0. Claim
Invariantsbe-inv-eattestation-prescription-standard: Every service request in supporting info SHALL have an BeExtPrescriptionRequesterStandard (supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).extension('https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-prescription-requester-standard').count() = supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).count())
be-inv-bodySite: BodySite and laterality CAN only occur in a specialised medicine attestation or a dentistry attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine' or code = 'dentistry').empty() implies Claim.item.bodySite.empty())
be-inv-eattestation-create-cancel: Creation requires empty identifier (Claim.identifier.where(system = 'https://www.mycarenet.be/eattest').empty().not() implies Claim.item.empty() and Claim.total.empty() and Claim.careTeam.empty())
be-inv-gmf-holder: GMF holder CAN only occur in a GP's attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'other').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty())
be-inv-location: The location SHALL be indicated using a value from https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd if it is a department code, or a https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi for an organization (Claim.item.(location as Reference).empty().not() implies ( Claim.item.(location as Reference).resolve().type.memberOf('https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd') or Claim.item.(location as Reference).resolve().managingOrganization.resolve().identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') or Claim.item.(location as Reference).resolve().managingOrganization.identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') ))
be-inv-medical-advisor-decision-nr: Medical advisor decision number SHALL occur for physiotherapy and SHALL NOT for the other eattestations (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').exists() implies Claim.item.count() <= Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').count() and Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').empty() implies Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').empty())
be-inv-oral-hygienist: Oral Hygienist CAN only occur a dentist's attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').empty() implies Claim.careTeam.qualification.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty').where(code = 'persoraldentalhygienist').empty())
be-inv-toothNumber: BodySite SHALL contain a value from BeVSToothNumberBodySite, if available, in a dentistry attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').exists() implies (Claim.item.bodySite.coding.empty() or Claim.item.bodySite.coding.memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-toothnumber-bodysite') ))
be-inv-trainee: Trainee CAN only occur in a GP's attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'assist').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty())
be-inv-transplantation: Transplantation CAN only occur in a specialised medicine attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine').empty() implies Claim.supportingInfo.code.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-claim-transplantation-code').empty())
2. Claim.extension
SlicingThis element introduces a set of slices on Claim.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Claim.extension:supplement
    Slice Namesupplement
    Control0..1
    TypeExtension(BeExtEAttestationSupplement) (Extension Type: Money)
    Must Supporttrue
    6. Claim.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Must Supporttrue
    SlicingThis element introduces a set of slices on Claim.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ system
    • 8. Claim.identifier:eattestid
      Slice Nameeattestid
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..1
      Must Supporttrue
      10. Claim.identifier:eattestid.system
      Control1..?
      Fixed Valuehttps://www.mycarenet.be/eattest
      12. Claim.identifier:eattestid.value
      Control1..?
      14. Claim.status
      Pattern Valueactive
      16. Claim.type
      18. Claim.type.coding
      Control1..1
      20. Claim.type.coding.system
      Control1..?
      22. Claim.type.coding.code
      Control1..?
      24. Claim.subType
      Control1..?
      BindingUnless not suitable, these codes SHALL be taken from Attestation types
      (extensible to https://www.ehealth.fgov.be/standards/fhir/eattestation/ValueSet/be-vs-eattestationtypes)
      Must Supporttrue
      26. Claim.use
      Must Supporttrue
      Pattern Valueclaim
      28. Claim.patient
      TypeReference(BePatient)
      Must Supporttrue
      30. Claim.enterer
      Control1..?
      TypeReference(BePractitionerRole)
      Must Supporttrue
      32. Claim.provider
      TypeReference(BePractitionerRole, BeOrganization)
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      34. Claim.priority
      36. Claim.priority.coding
      Pattern Value{
        "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
        "code" : "stat"
      }
      38. Claim.payee
      40. Claim.payee.type
      42. Claim.payee.type.coding
      Pattern Value{
        "system" : "http://terminology.hl7.org/CodeSystem/payeetype",
        "code" : "subscriber"
      }
      44. Claim.payee.party
      TypeReference(BePatient)
      46. Claim.careTeam
      Must Supporttrue
      48. Claim.careTeam.provider
      50. Claim.careTeam.provider.identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      52. Claim.careTeam.provider.identifier.system
      Pattern Valuehttps://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi
      54. Claim.careTeam.role
      Control1..?
      Must Supporttrue
      56. Claim.careTeam.qualification
      Control1..?
      BindingThe codes SHALL be taken from List of health care parties in Belgium
      (required to https://www.ehealth.fgov.be/standards/fhir/core/ValueSet/be-vs-cd-hcparty)
      Must Supporttrue
      58. Claim.supportingInfo
      Must Supporttrue
      60. Claim.supportingInfo.code
      Must Supporttrue
      62. Claim.supportingInfo.value[x]
      [x] NoteSee Choice of Data Types for further information about how to use [x]
      SlicingThis element introduces a set of slices on Claim.supportingInfo.value[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • type @ $this
      • 64. Claim.supportingInfo.value[x]:valueReference
        Slice NamevalueReference
        Control0..1
        TypeReference(Resource)
        [x] NoteSee Choice of Data Types for further information about how to use [x]
        Must Supporttrue
        66. Claim.insurance
        68. Claim.insurance.sequence
        Pattern Value1
        70. Claim.insurance.focal
        Pattern Valuetrue
        72. Claim.insurance.coverage
        74. Claim.insurance.coverage.display
        Pattern Valueuse of mandatory insurance coverage, no further details provided here.
        76. Claim.item
        Must Supporttrue
        78. Claim.item.extension
        SlicingThis element introduces a set of slices on Claim.item.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 80. Claim.item.extension:eid
          Slice Nameeid
          Control0..1
          TypeExtension(BeExtPatientIdentityDocument) (Complex Extension)
          Must Supporttrue
          82. Claim.item.extension:preAuthRef
          Slice NamepreAuthRef
          Control0..1
          TypeExtension(BeExtEAttestationItemPreAuthRef) (Extension Type: string)
          Must Supporttrue
          84. Claim.item.extension:supplement
          Slice Namesupplement
          Control0..1
          TypeExtension(BeExtEAttestationItemSupplement) (Extension Type: Money)
          Must Supporttrue
          86. Claim.item.careTeamSequence
          Control1..?
          Must Supporttrue
          88. Claim.item.informationSequence
          Must Supporttrue
          90. Claim.item.productOrService
          Must Supporttrue
          92. Claim.item.productOrService.coding
          Control1..1
          Must Supporttrue
          94. Claim.item.productOrService.coding.system
          Control1..?
          Must Supporttrue
          Pattern Valuehttps://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature
          96. Claim.item.productOrService.coding.code
          Control1..?
          Must Supporttrue
          98. Claim.item.serviced[x]
          Control1..?
          [x] NoteSee Choice of Data Types for further information about how to use [x]
          SlicingThis element introduces a set of slices on Claim.item.serviced[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • type @ $this
          • 100. Claim.item.serviced[x]:servicedDate
            Slice NameservicedDate
            Control1..1
            Typedate
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            102. Claim.item.location[x]
            [x] NoteSee Choice of Data Types for further information about how to use [x]
            SlicingThis element introduces a set of slices on Claim.item.location[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • type @ $this
            • 104. Claim.item.location[x]:locationReference
              Slice NamelocationReference
              Control0..1
              TypeReference(Location)
              [x] NoteSee Choice of Data Types for further information about how to use [x]
              Must Supporttrue
              106. Claim.item.quantity
              Control1..?
              Must Supporttrue
              108. Claim.item.unitPrice
              Control1..?
              Must Supporttrue
              110. Claim.item.net
              Control1..?
              Must Supporttrue
              112. Claim.item.bodySite
              Must Supporttrue
              114. Claim.item.bodySite.extension:bodyLaterality
              Slice NamebodyLaterality
              Control0..1
              TypeExtension(BeExtLaterality) (Extension Type: Coding)
              Must Supporttrue
              116. Claim.item.bodySite.extension:bodyLaterality.value[x]
              BindingThe codes SHALL be taken from Basic Laterality
              (required to https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-basic-laterality)
              [x] NoteSee Choice of Data Types for further information about how to use [x]
              118. Claim.item.bodySite.coding
              BindingThe codes SHALL be taken from Body Site
              (required to https://www.ehealth.fgov.be/standards/fhir/core-clinical/ValueSet/be-vs-bodysite)
              120. Claim.total
              Must Supporttrue

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

              0. Claim
              Definition

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

              ShortClaim, Pre-determination or Pre-authorization
              Comments

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

              Control0..*
              Is Modifierfalse
              Summaryfalse
              Alternate NamesAdjudication Request, Preauthorization Request, Predetermination Request
              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
              dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
              dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
              dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
              dom-6: A resource should have narrative for robust management (text.`div`.exists())
              be-inv-eattestation-prescription-standard: Every service request in supporting info SHALL have an BeExtPrescriptionRequesterStandard (supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).extension('https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-prescription-requester-standard').count() = supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).count())
              be-inv-bodySite: BodySite and laterality CAN only occur in a specialised medicine attestation or a dentistry attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine' or code = 'dentistry').empty() implies Claim.item.bodySite.empty())
              be-inv-eattestation-create-cancel: Creation requires empty identifier (Claim.identifier.where(system = 'https://www.mycarenet.be/eattest').empty().not() implies Claim.item.empty() and Claim.total.empty() and Claim.careTeam.empty())
              be-inv-gmf-holder: GMF holder CAN only occur in a GP's attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'other').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty())
              be-inv-location: The location SHALL be indicated using a value from https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd if it is a department code, or a https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi for an organization (Claim.item.(location as Reference).empty().not() implies ( Claim.item.(location as Reference).resolve().type.memberOf('https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd') or Claim.item.(location as Reference).resolve().managingOrganization.resolve().identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') or Claim.item.(location as Reference).resolve().managingOrganization.identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') ))
              be-inv-medical-advisor-decision-nr: Medical advisor decision number SHALL occur for physiotherapy and SHALL NOT for the other eattestations (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').exists() implies Claim.item.count() <= Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').count() and Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').empty() implies Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').empty())
              be-inv-oral-hygienist: Oral Hygienist CAN only occur a dentist's attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').empty() implies Claim.careTeam.qualification.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty').where(code = 'persoraldentalhygienist').empty())
              be-inv-toothNumber: BodySite SHALL contain a value from BeVSToothNumberBodySite, if available, in a dentistry attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').exists() implies (Claim.item.bodySite.coding.empty() or Claim.item.bodySite.coding.memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-toothnumber-bodysite') ))
              be-inv-trainee: Trainee CAN only occur in a GP's attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'assist').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty())
              be-inv-transplantation: Transplantation CAN only occur in a specialised medicine attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine').empty() implies Claim.supportingInfo.code.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-claim-transplantation-code').empty())
              2. Claim.implicitRules
              Definition

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

              ShortA set of rules under which this content was created
              Comments

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

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

              An Extension


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

              ShortExtensionAdditional content defined by implementations
              Comments

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

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

                Optional Extension Element - found in all resources.

                ShortOptional Extensions Element
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(BeExtEAttestationSupplement) (Extension Type: Money)
                Is Modifierfalse
                Must Supporttrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                8. Claim.modifierExtension
                Definition

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

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

                ShortExtensions that cannot be ignored
                Comments

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

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

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

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

                A unique identifier assigned to this claim.

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

                Allows claims to be distinguished and referenced.

                Alternate NamesClaim Number
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on Claim.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • value @ system
                • 12. Claim.identifier:eattestid
                  Slice Nameeattestid
                  Definition

                  A unique identifier assigned to this claim.

                  ShortBusiness Identifier for claim
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control0..1*
                  TypeIdentifier
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Requirements

                  Allows claims to be distinguished and referenced.

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

                  The purpose of this identifier.

                  Shortusual | official | temp | secondary | old (If known)
                  Comments

                  Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                  Control0..1
                  BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
                  (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                  Identifies the purpose for this identifier, if known .

                  Typecode
                  Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

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

                  Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                  ShortThe namespace for the identifier value
                  Comments

                  Identifier.system is always case sensitive.

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

                  There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                  Fixed Valuehttps://www.mycarenet.be/eattest
                  Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  18. Claim.identifier:eattestid.value
                  Definition

                  The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                  ShortThe value that is unique
                  Comments

                  If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                  Control10..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Example<br/><b>General</b>:123456
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  20. Claim.status
                  Definition

                  The status of the resource instance.

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

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

                  Control1..1
                  BindingThe codes SHALL be taken from FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.0.1
                  (required to http://hl7.org/fhir/ValueSet/fm-status|4.0.1)

                  A code specifying the state of the resource instance.

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

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

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

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

                  ShortCategory or discipline
                  Comments

                  The majority of jurisdictions use: oral, pharmacy, vision, professional and institutional, or variants on those terms, as the general styles of claims. The valueset is extensible to accommodate other jurisdictional requirements.

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

                  The type or discipline-style of the claim.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Requirements

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

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

                  A reference to a code defined by a terminology system.

                  ShortCode defined by a terminology system
                  Comments

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

                  Control10..1*
                  TypeCoding
                  Is Modifierfalse
                  Summarytrue
                  Requirements

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

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

                  The identification of the code system that defines the meaning of the symbol in the code.

                  ShortIdentity of the terminology system
                  Comments

                  The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

                  Need to be unambiguous about the source of the definition of the symbol.

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

                  A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                  ShortSymbol in syntax defined by the system
                  Control10..1
                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Need to refer to a particular code in the system.

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

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

                  ShortMore granular claim type
                  Comments

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

                  Control10..1
                  BindingUnless not suitable, these codes SHALL be taken from For example codes, see Attestation typeshttp://hl7.org/fhir/ValueSet/claim-subtype
                  (extensible to https://www.ehealth.fgov.be/standards/fhir/eattestation/ValueSet/be-vs-eattestationtypes)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Requirements

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

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

                  A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.

                  Shortclaim | preauthorization | predetermination
                  Control1..1
                  BindingThe codes SHALL be taken from Usehttp://hl7.org/fhir/ValueSet/claim-use|4.0.1
                  (required to http://hl7.org/fhir/ValueSet/claim-use|4.0.1)

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

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

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

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

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

                  ShortThe recipient of the products and services
                  Control1..1
                  TypeReference(BePatient, Patient)
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

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

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

                  The date this resource was created.

                  ShortResource creation date
                  Comments

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

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

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

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

                  Individual who created the claim, predetermination or preauthorization.

                  ShortAuthor of the claim
                  Control10..1
                  TypeReference(BePractitionerRole, Practitioner, PractitionerRole)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Requirements

                  Some jurisdictions require the contact information for personnel completing claims.

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

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

                  ShortParty responsible for the claim
                  Comments

                  Typically this field would be 1..1 where this party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below.

                  Control1..1
                  TypeReference(BePractitionerRole, BeOrganization, Practitioner, PractitionerRole, Organization)
                  Is Modifierfalse
                  Must Supporttrue
                  Must Support TypesNo must-support rules about the choice of types/profiles
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  42. Claim.priority
                  Definition

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

                  ShortDesired processing ugency
                  Comments

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

                  Control1..1
                  BindingFor example codes, see ProcessPriorityCodeshttp://hl7.org/fhir/ValueSet/process-priority
                  (example to http://hl7.org/fhir/ValueSet/process-priority)

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

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Requirements

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

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

                  A reference to a code defined by a terminology system.

                  ShortCode defined by a terminology system
                  Comments

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

                  Control0..*
                  TypeCoding
                  Is Modifierfalse
                  Summarytrue
                  Requirements

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

                  Pattern Value{
                    "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
                    "code" : "stat"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  46. Claim.careTeam
                  Definition

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

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

                  Common to identify the responsible and supporting practitioners.

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

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

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

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

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

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

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

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

                  A number to uniquely identify care team entries.

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

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

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

                  Member of the team who provided the product or service.

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

                  Often a regulatory requirement to specify the responsible provider.

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

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

                  ShortFunction within the team
                  Comments

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

                  Control10..1
                  BindingFor example codes, see ClaimCareTeamRoleCodeshttp://hl7.org/fhir/ValueSet/claim-careteamrole
                  (example to http://hl7.org/fhir/ValueSet/claim-careteamrole)

                  The role codes for the care team members.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Requirements

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

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

                  The qualification of the practitioner which is applicable for this service.

                  ShortPractitioner credential or specialization
                  Control10..1
                  BindingThe codes SHALL be taken from For example codes, see List of health care parties in Belgiumhttp://hl7.org/fhir/ValueSet/provider-qualification
                  (required to https://www.ehealth.fgov.be/standards/fhir/core/ValueSet/be-vs-cd-hcparty)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Requirements

                  Need to specify which qualification a provider is delivering the product or service under.

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

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

                  ShortSupporting information
                  Comments

                  Often there are multiple jurisdiction specific valuesets which are required.

                  Control0..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Requirements

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

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

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

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

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

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

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

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

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

                  A number to uniquely identify supporting information entries.

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

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

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

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

                  ShortClassification of the supplied information
                  Comments

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

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

                  The valuset used for additional information category codes.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

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

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

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

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

                  The valuset used for additional information codes.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Requirements

                  Required to identify the kind of additional information.

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

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

                  ShortData to be provided
                  Comments

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

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

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

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on Claim.supportingInfo.value[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • type @ $this
                  • 70. Claim.supportingInfo.value[x]:valueReference
                    Slice NamevalueReference
                    Definition

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

                    ShortData to be provided
                    Comments

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

                    Control0..1
                    TypeReference(Resource), boolean, string, Quantity, Attachment
                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Requirements

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

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

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

                    ShortPatient insurance information
                    Comments

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

                    Control1..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summarytrue
                    Requirements

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

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

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

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

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

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

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

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

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

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

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

                    To maintain order of the coverages.

                    Pattern Value1
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    78. Claim.insurance.focal
                    Definition

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

                    ShortCoverage to be used for adjudication
                    Comments

                    A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies.

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

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

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

                    Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.

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

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

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

                    Plain text narrative that identifies the resource in addition to the resource reference.

                    ShortText alternative for the resource
                    Comments

                    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Pattern Valueuse of mandatory insurance coverage, no further details provided here.
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    84. Claim.item
                    Definition

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

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

                    The items to be processed for adjudication.

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

                    An Extension


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

                    ShortExtensionAdditional content defined by implementations
                    Comments

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

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

                      Data from the Belgian eID

                      ShortBeExtPatientIdentityDocument
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(BeExtPatientIdentityDocument) (Complex Extension)
                      Is Modifierfalse
                      Must Supporttrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      90. Claim.item.extension:preAuthRef
                      Slice NamepreAuthRef
                      Definition

                      Optional Extension Element - found in all resources.

                      ShortOptional Extensions Element
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(BeExtEAttestationItemPreAuthRef) (Extension Type: string)
                      Is Modifierfalse
                      Must Supporttrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      92. Claim.item.extension:supplement
                      Slice Namesupplement
                      Definition

                      Optional Extension Element - found in all resources.

                      ShortOptional Extensions Element
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(BeExtEAttestationItemSupplement) (Extension Type: Money)
                      Is Modifierfalse
                      Must Supporttrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      94. Claim.item.modifierExtension
                      Definition

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

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

                      ShortExtensions that cannot be ignored even if unrecognized
                      Comments

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

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

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

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

                      A number to uniquely identify item entries.

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

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

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

                      CareTeam members related to this service or product.

                      ShortApplicable careTeam members
                      Control10..*
                      TypepositiveInt
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Requirements

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

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

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

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

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

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

                      When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.

                      ShortBilling, service, product, or drug code
                      Comments

                      If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                      Control1..1
                      BindingFor example codes, see USCLSCodeshttp://hl7.org/fhir/ValueSet/service-uscls
                      (example to http://hl7.org/fhir/ValueSet/service-uscls)

                      Allowable service and product codes.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Necessary to state what was provided or done.

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

                      A reference to a code defined by a terminology system.

                      ShortCode defined by a terminology system
                      Comments

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

                      Control10..1*
                      TypeCoding
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Requirements

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

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

                      The identification of the code system that defines the meaning of the symbol in the code.

                      ShortIdentity of the terminology system
                      Comments

                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

                      Need to be unambiguous about the source of the definition of the symbol.

                      Pattern Valuehttps://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      108. Claim.item.productOrService.coding.code
                      Definition

                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                      ShortSymbol in syntax defined by the system
                      Control10..1
                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Need to refer to a particular code in the system.

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

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

                      ShortDate or dates of service or product delivery
                      Control10..1
                      Typedate, Period
                      [x] NoteSee Choice of Data Types for further information about how to use [x]
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Requirements

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

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingThis element introduces a set of slices on Claim.item.serviced[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                      • type @ $this
                      • 112. Claim.item.serviced[x]:servicedDate
                        Slice NameservicedDate
                        Definition

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

                        ShortDate or dates of service or product delivery
                        Control10..1
                        Typedate, Period
                        [x] NoteSee Choice of Data Types for further information about how to use [x]
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summaryfalse
                        Requirements

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

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

                        Where the product or service was provided.

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

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

                        TypeChoice of: CodeableConcept, Address, Reference(Location)
                        [x] NoteSee Choice of Data Types for further information about how to use [x]
                        Is Modifierfalse
                        Summaryfalse
                        Requirements

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on Claim.item.location[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
                        • type @ $this
                        • 116. Claim.item.location[x]:locationReference
                          Slice NamelocationReference
                          Definition

                          Where the product or service was provided.

                          ShortPlace of service or where product was supplied
                          Control0..1
                          TypeReference(Location), Address, CodeableConcept
                          [x] NoteSee Choice of Data Types for further information about how to use [x]
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Requirements

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

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

                          The number of repetitions of a service or product.

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

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

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

                          If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                          ShortFee, charge or cost per item
                          Control10..1
                          TypeMoney
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Requirements

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

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

                          The quantity times the unit price for an additional service or product or charge.

                          ShortTotal item cost
                          Comments

                          For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                          Control10..1
                          TypeMoney
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Requirements

                          Provides the total amount claimed for the group (if a grouper) or the line item.

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

                          Physical service site on the patient (limb, tooth, etc.).

                          ShortAnatomical location
                          Comments

                          For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

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

                          The code for the teeth, quadrant, sextant and arch.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Requirements

                          Allows insurer to validate specific procedures.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          126. Claim.item.bodySite.extension:bodyLaterality
                          Slice NamebodyLaterality
                          Definition

                          An explicit statement of laterality of a lesion, or a treatment, etc.

                          ShortBeExtLaterality
                          Control0..1
                          TypeExtension(BeExtLaterality) (Extension Type: Coding)
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          128. Claim.item.bodySite.extension:bodyLaterality.extension
                          Definition

                          An Extension


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

                          ShortExtensionAdditional content defined by implementations
                          Comments

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

                          Control0..0*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on Claim.item.bodySite.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 130. Claim.item.bodySite.extension:bodyLaterality.url
                            Definition

                            Source of the definition for the extension code - a logical name or a URL.

                            Shortidentifies the meaning of the extension
                            Comments

                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                            Control1..1
                            Typeuri
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            Fixed Valuehttps://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality
                            132. Claim.item.bodySite.extension:bodyLaterality.value[x]
                            Definition

                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                            ShortValue of extension
                            Control0..1
                            BindingThe codes SHALL be taken from For codes, see Basic Laterality
                            (required to https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-basic-laterality)
                            TypeCoding, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                            [x] NoteSee Choice of Data Types for further information about how to use [x]
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            134. Claim.item.bodySite.coding
                            Definition

                            A reference to a code defined by a terminology system.

                            ShortCode defined by a terminology system
                            Comments

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

                            Control0..*
                            BindingThe codes SHALL be taken from For codes, see Body Site
                            (required to https://www.ehealth.fgov.be/standards/fhir/core-clinical/ValueSet/be-vs-bodysite)
                            TypeCoding
                            Is Modifierfalse
                            Summarytrue
                            Requirements

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

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

                            The total value of the all the items in the claim.

                            ShortTotal claim cost
                            Control0..1
                            TypeMoney
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Requirements

                            Used for control total purposes.

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

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

                            0. Claim
                            Definition

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

                            ShortClaim, Pre-determination or Pre-authorization
                            Comments

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

                            Control0..*
                            Is Modifierfalse
                            Summaryfalse
                            Alternate NamesAdjudication Request, Preauthorization Request, Predetermination Request
                            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                            dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                            dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                            dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                            dom-6: A resource should have narrative for robust management (text.`div`.exists())
                            be-inv-eattestation-prescription-standard: Every service request in supporting info SHALL have an BeExtPrescriptionRequesterStandard (supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).extension('https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-prescription-requester-standard').count() = supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).count())
                            be-inv-bodySite: BodySite and laterality CAN only occur in a specialised medicine attestation or a dentistry attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine' or code = 'dentistry').empty() implies Claim.item.bodySite.empty())
                            be-inv-eattestation-create-cancel: Creation requires empty identifier (Claim.identifier.where(system = 'https://www.mycarenet.be/eattest').empty().not() implies Claim.item.empty() and Claim.total.empty() and Claim.careTeam.empty())
                            be-inv-gmf-holder: GMF holder CAN only occur in a GP's attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'other').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty())
                            be-inv-location: The location SHALL be indicated using a value from https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd if it is a department code, or a https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi for an organization (Claim.item.(location as Reference).empty().not() implies ( Claim.item.(location as Reference).resolve().type.memberOf('https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd') or Claim.item.(location as Reference).resolve().managingOrganization.resolve().identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') or Claim.item.(location as Reference).resolve().managingOrganization.identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') ))
                            be-inv-medical-advisor-decision-nr: Medical advisor decision number SHALL occur for physiotherapy and SHALL NOT for the other eattestations (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').exists() implies Claim.item.count() <= Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').count() and Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').empty() implies Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').empty())
                            be-inv-oral-hygienist: Oral Hygienist CAN only occur a dentist's attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').empty() implies Claim.careTeam.qualification.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty').where(code = 'persoraldentalhygienist').empty())
                            be-inv-toothNumber: BodySite SHALL contain a value from BeVSToothNumberBodySite, if available, in a dentistry attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').exists() implies (Claim.item.bodySite.coding.empty() or Claim.item.bodySite.coding.memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-toothnumber-bodysite') ))
                            be-inv-trainee: Trainee CAN only occur in a GP's attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'assist').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty())
                            be-inv-transplantation: Transplantation CAN only occur in a specialised medicine attestation (Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine').empty() implies Claim.supportingInfo.code.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-claim-transplantation-code').empty())
                            2. Claim.id
                            Definition

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

                            ShortLogical id of this artifact
                            Comments

                            The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

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

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

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

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

                            ShortA set of rules under which this content was created
                            Comments

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

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

                            The base language in which the resource is written.

                            ShortLanguage of the resource content
                            Comments

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

                            Control0..1
                            BindingThe codes SHOULD be taken from CommonLanguages
                            (preferred to http://hl7.org/fhir/ValueSet/languages)

                            A human language.

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

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

                            ShortText summary of the resource, for human interpretation
                            Comments

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

                            Control0..1
                            TypeNarrative
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesnarrative, html, xhtml, display
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            12. Claim.contained
                            Definition

                            These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                            ShortContained, inline Resources
                            Comments

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

                            Control0..*
                            TypeResource
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesinline resources, anonymous resources, contained resources
                            14. Claim.extension
                            Definition

                            An Extension

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

                              Optional Extension Element - found in all resources.

                              ShortOptional Extensions Element
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(BeExtEAttestationSupplement) (Extension Type: Money)
                              Is Modifierfalse
                              Must Supporttrue
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              18. Claim.modifierExtension
                              Definition

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

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

                              ShortExtensions that cannot be ignored
                              Comments

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

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

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

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

                              A unique identifier assigned to this claim.

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

                              Allows claims to be distinguished and referenced.

                              Alternate NamesClaim Number
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              SlicingThis element introduces a set of slices on Claim.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
                              • value @ system
                              • 22. Claim.identifier:eattestid
                                Slice Nameeattestid
                                Definition

                                A unique identifier assigned to this claim.

                                ShortBusiness Identifier for claim
                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                Control0..1
                                TypeIdentifier
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Requirements

                                Allows claims to be distinguished and referenced.

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

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

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                26. Claim.identifier:eattestid.extension
                                Definition

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

                                ShortAdditional content defined by implementations
                                Comments

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

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

                                  The purpose of this identifier.

                                  Shortusual | official | temp | secondary | old (If known)
                                  Comments

                                  Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                  Control0..1
                                  BindingThe codes SHALL be taken from IdentifierUse
                                  (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                  Identifies the purpose for this identifier, if known .

                                  Typecode
                                  Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Requirements

                                  Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

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

                                  A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                  ShortDescription of identifier
                                  Comments

                                  This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                  Control0..1
                                  BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                  (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                                  A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Allows users to make use of identifiers when the identifier system is not known.

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

                                  Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                  ShortThe namespace for the identifier value
                                  Comments

                                  Identifier.system is always case sensitive.

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

                                  There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                  Fixed Valuehttps://www.mycarenet.be/eattest
                                  Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  34. Claim.identifier:eattestid.value
                                  Definition

                                  The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                  ShortThe value that is unique
                                  Comments

                                  If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                  Control1..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summarytrue
                                  Example<br/><b>General</b>:123456
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  36. Claim.identifier:eattestid.period
                                  Definition

                                  Time period during which identifier is/was valid for use.

                                  ShortTime period when id is/was valid for use
                                  Control0..1
                                  TypePeriod
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  38. Claim.identifier:eattestid.assigner
                                  Definition

                                  Organization that issued/manages the identifier.

                                  ShortOrganization that issued id (may be just text)
                                  Comments

                                  The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                  Control0..1
                                  TypeReference(Organization)
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  40. Claim.status
                                  Definition

                                  The status of the resource instance.

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

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

                                  Control1..1
                                  BindingThe codes SHALL be taken from FinancialResourceStatusCodes
                                  (required to http://hl7.org/fhir/ValueSet/fm-status|4.0.1)

                                  A code specifying the state of the resource instance.

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

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

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

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

                                  ShortCategory or discipline
                                  Comments

                                  The majority of jurisdictions use: oral, pharmacy, vision, professional and institutional, or variants on those terms, as the general styles of claims. The valueset is extensible to accommodate other jurisdictional requirements.

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

                                  The type or discipline-style of the claim.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

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

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

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

                                  ShortUnique id for inter-element referencing
                                  Control0..1
                                  Typestring
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  46. Claim.type.extension
                                  Definition

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

                                  ShortAdditional content defined by implementations
                                  Comments

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

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

                                    A reference to a code defined by a terminology system.

                                    ShortCode defined by a terminology system
                                    Comments

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

                                    Control1..1
                                    TypeCoding
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

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

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

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

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    52. Claim.type.coding.extension
                                    Definition

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

                                    ShortAdditional content defined by implementations
                                    Comments

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

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

                                      The identification of the code system that defines the meaning of the symbol in the code.

                                      ShortIdentity of the terminology system
                                      Comments

                                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

                                      Need to be unambiguous about the source of the definition of the symbol.

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

                                      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                      ShortVersion of the system - if relevant
                                      Comments

                                      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                      NoteThis is a business versionId, not a resource version id (see discussion)
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      58. Claim.type.coding.code
                                      Definition

                                      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                      ShortSymbol in syntax defined by the system
                                      Control1..1
                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Need to refer to a particular code in the system.

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

                                      A representation of the meaning of the code in the system, following the rules of the system.

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

                                      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

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

                                      Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                      ShortIf this coding was chosen directly by the user
                                      Comments

                                      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                                      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                      ShortPlain text representation of the concept
                                      Comments

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

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

                                      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

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

                                      ShortMore granular claim type
                                      Comments

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

                                      Control1..1
                                      BindingUnless not suitable, these codes SHALL be taken from Attestation types
                                      (extensible to https://www.ehealth.fgov.be/standards/fhir/eattestation/ValueSet/be-vs-eattestationtypes)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Requirements

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

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

                                      A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.

                                      Shortclaim | preauthorization | predetermination
                                      Control1..1
                                      BindingThe codes SHALL be taken from Use
                                      (required to http://hl7.org/fhir/ValueSet/claim-use|4.0.1)

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

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

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

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

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

                                      ShortThe recipient of the products and services
                                      Control1..1
                                      TypeReference(BePatient)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

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

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

                                      The period for which charges are being submitted.

                                      ShortRelevant time frame for the claim
                                      Comments

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

                                      Control0..1
                                      TypePeriod
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

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

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

                                      The date this resource was created.

                                      ShortResource creation date
                                      Comments

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

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

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

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

                                      Individual who created the claim, predetermination or preauthorization.

                                      ShortAuthor of the claim
                                      Control1..1
                                      TypeReference(BePractitionerRole)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Requirements

                                      Some jurisdictions require the contact information for personnel completing claims.

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

                                      The Insurer who is target of the request.

                                      ShortTarget
                                      Control0..1
                                      TypeReference(Organization)
                                      Is Modifierfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      80. Claim.provider
                                      Definition

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

                                      ShortParty responsible for the claim
                                      Comments

                                      Typically this field would be 1..1 where this party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below.

                                      Control1..1
                                      TypeReference(BePractitionerRole, BeOrganization)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Must Support TypesNo must-support rules about the choice of types/profiles
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      82. Claim.priority
                                      Definition

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

                                      ShortDesired processing ugency
                                      Comments

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

                                      Control1..1
                                      BindingFor example codes, see ProcessPriorityCodes
                                      (example to http://hl7.org/fhir/ValueSet/process-priority)

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

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

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

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

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

                                      ShortUnique id for inter-element referencing
                                      Control0..1
                                      Typestring
                                      Is Modifierfalse
                                      XML FormatIn the XML format, this property is represented as an attribute.
                                      Summaryfalse
                                      86. Claim.priority.extension
                                      Definition

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

                                      ShortAdditional content defined by implementations
                                      Comments

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

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

                                        A reference to a code defined by a terminology system.

                                        ShortCode defined by a terminology system
                                        Comments

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

                                        Control0..*
                                        TypeCoding
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

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

                                        Pattern Value{
                                          "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
                                          "code" : "stat"
                                        }
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        90. Claim.priority.text
                                        Definition

                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                        ShortPlain text representation of the concept
                                        Comments

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

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

                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

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

                                        ShortFor whom to reserve funds
                                        Comments

                                        This field is only used for preauthorizations.

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

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

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summaryfalse
                                        Requirements

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

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

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

                                        ShortPrior or corollary claims
                                        Comments

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

                                        Control0..*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Summaryfalse
                                        Requirements

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

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

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

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        98. Claim.related.extension
                                        Definition

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

                                        ShortAdditional content defined by implementations
                                        Comments

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

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

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

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

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

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

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

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

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

                                        Reference to a related claim.

                                        ShortReference to the related claim
                                        Control0..1
                                        TypeReference(Claim)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Requirements

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

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

                                        A code to convey how the claims are related.

                                        ShortHow the reference claim is related
                                        Comments

                                        For example, prior claim or umbrella.

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

                                        Relationship of this claim to a related Claim.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summaryfalse
                                        Requirements

                                        Some insurers need a declaration of the type of relationship.

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

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

                                        ShortFile or case reference
                                        Comments

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

                                        Control0..1
                                        TypeIdentifier
                                        Is Modifierfalse
                                        Summaryfalse
                                        Requirements

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

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

                                        Prescription to support the dispensing of pharmacy, device or vision products.

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

                                        Required to authorize the dispensing of controlled substances and devices.

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

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

                                        ShortOriginal prescription if superseded by fulfiller
                                        Comments

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

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

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

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

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

                                        ShortRecipient of benefits payable
                                        Comments

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

                                        Control0..1
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Summaryfalse
                                        Requirements

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

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

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

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        116. Claim.payee.extension
                                        Definition

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

                                        ShortAdditional content defined by implementations
                                        Comments

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

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

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

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

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

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

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

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

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

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

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

                                        A code for the party to be reimbursed.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summaryfalse
                                        Requirements

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

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

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

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        124. Claim.payee.type.extension
                                        Definition

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

                                        ShortAdditional content defined by implementations
                                        Comments

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

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

                                          A reference to a code defined by a terminology system.

                                          ShortCode defined by a terminology system
                                          Comments

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

                                          Control0..*
                                          TypeCoding
                                          Is Modifierfalse
                                          Summarytrue
                                          Requirements

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

                                          Pattern Value{
                                            "system" : "http://terminology.hl7.org/CodeSystem/payeetype",
                                            "code" : "subscriber"
                                          }
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          128. Claim.payee.type.text
                                          Definition

                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                          ShortPlain text representation of the concept
                                          Comments

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

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

                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

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

                                          ShortRecipient reference
                                          Comments

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

                                          Control0..1
                                          TypeReference(BePatient)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Requirements

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

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

                                          A reference to a referral resource.

                                          ShortTreatment referral
                                          Comments

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

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

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

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

                                          Facility where the services were provided.

                                          ShortServicing facility
                                          Control0..1
                                          TypeReference(Location)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Requirements

                                          Insurance adjudication can be dependant on where services were delivered.

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

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

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

                                          Common to identify the responsible and supporting practitioners.

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

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

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          140. Claim.careTeam.extension
                                          Definition

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

                                          ShortAdditional content defined by implementations
                                          Comments

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

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

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

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

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

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

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

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

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

                                          A number to uniquely identify care team entries.

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

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

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

                                          Member of the team who provided the product or service.

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

                                          Often a regulatory requirement to specify the responsible provider.

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

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

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          150. Claim.careTeam.provider.extension
                                          Definition

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

                                          ShortAdditional content defined by implementations
                                          Comments

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

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

                                            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                            ShortLiteral reference, Relative, internal or absolute URL
                                            Comments

                                            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                            Control0..1
                                            This element is affected by the following invariants: ref-1
                                            Typestring
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            154. Claim.careTeam.provider.type
                                            Definition

                                            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                            ShortType the reference refers to (e.g. "Patient")
                                            Comments

                                            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                            Control0..1
                                            BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                            (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                            Aa resource (or, for logical models, the URI of the logical model).

                                            Typeuri
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            156. Claim.careTeam.provider.identifier
                                            Definition

                                            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                            ShortLogical reference, when literal reference is not known
                                            Comments

                                            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                            NoteThis is a business identifier, not a resource identifier (see discussion)
                                            Control0..1
                                            TypeIdentifier
                                            Is Modifierfalse
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            158. Claim.careTeam.provider.identifier.id
                                            Definition

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

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            160. Claim.careTeam.provider.identifier.extension
                                            Definition

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

                                            ShortAdditional content defined by implementations
                                            Comments

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

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

                                              The purpose of this identifier.

                                              Shortusual | official | temp | secondary | old (If known)
                                              Comments

                                              Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                              Control0..1
                                              BindingThe codes SHALL be taken from IdentifierUse
                                              (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                              Identifies the purpose for this identifier, if known .

                                              Typecode
                                              Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

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

                                              A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                                              ShortDescription of identifier
                                              Comments

                                              This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                              Control0..1
                                              BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                              (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                                              A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summarytrue
                                              Requirements

                                              Allows users to make use of identifiers when the identifier system is not known.

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

                                              Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                              ShortThe namespace for the identifier value
                                              Comments

                                              Identifier.system is always case sensitive.

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

                                              There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                              Pattern Valuehttps://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi
                                              Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              168. Claim.careTeam.provider.identifier.value
                                              Definition

                                              The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                              ShortThe value that is unique
                                              Comments

                                              If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Example<br/><b>General</b>:123456
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              170. Claim.careTeam.provider.identifier.period
                                              Definition

                                              Time period during which identifier is/was valid for use.

                                              ShortTime period when id is/was valid for use
                                              Control0..1
                                              TypePeriod
                                              Is Modifierfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              172. Claim.careTeam.provider.identifier.assigner
                                              Definition

                                              Organization that issued/manages the identifier.

                                              ShortOrganization that issued id (may be just text)
                                              Comments

                                              The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                              Control0..1
                                              TypeReference(Organization)
                                              Is Modifierfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              174. Claim.careTeam.provider.display
                                              Definition

                                              Plain text narrative that identifies the resource in addition to the resource reference.

                                              ShortText alternative for the resource
                                              Comments

                                              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              176. Claim.careTeam.responsible
                                              Definition

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

                                              ShortIndicator of the lead practitioner
                                              Comments

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

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

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

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

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

                                              ShortFunction within the team
                                              Comments

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

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

                                              The role codes for the care team members.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

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

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

                                              The qualification of the practitioner which is applicable for this service.

                                              ShortPractitioner credential or specialization
                                              Control1..1
                                              BindingThe codes SHALL be taken from List of health care parties in Belgium
                                              (required to https://www.ehealth.fgov.be/standards/fhir/core/ValueSet/be-vs-cd-hcparty)
                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Need to specify which qualification a provider is delivering the product or service under.

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

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

                                              ShortSupporting information
                                              Comments

                                              Often there are multiple jurisdiction specific valuesets which are required.

                                              Control0..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

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

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

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

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              186. Claim.supportingInfo.extension
                                              Definition

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

                                              ShortAdditional content defined by implementations
                                              Comments

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

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

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

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

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

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

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

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

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

                                              A number to uniquely identify supporting information entries.

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

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

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

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

                                              ShortClassification of the supplied information
                                              Comments

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

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

                                              The valuset used for additional information category codes.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

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

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

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

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

                                              The valuset used for additional information codes.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Required to identify the kind of additional information.

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

                                              The date when or period to which this information refers.

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

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

                                              ShortData to be provided
                                              Comments

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

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

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

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              SlicingThis element introduces a set of slices on Claim.supportingInfo.value[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                              • type @ $this
                                              • 200. Claim.supportingInfo.value[x]:valueReference
                                                Slice NamevalueReference
                                                Definition

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

                                                ShortData to be provided
                                                Comments

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

                                                Control0..1
                                                TypeReference(Resource)
                                                [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

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

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

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

                                                ShortExplanation for the information
                                                Comments

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

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

                                                Reason codes for the missing teeth.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

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

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

                                                Information about diagnoses relevant to the claim items.

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

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

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

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                208. Claim.diagnosis.extension
                                                Definition

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

                                                ShortAdditional content defined by implementations
                                                Comments

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

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

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

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

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

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

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

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

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

                                                A number to uniquely identify diagnosis entries.

                                                ShortDiagnosis instance identifier
                                                Comments

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

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

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

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

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

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

                                                Example ICD10 Diagnostic codes.

                                                TypeChoice of: CodeableConcept, Reference(Condition)
                                                [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

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

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

                                                When the condition was observed or the relative ranking.

                                                ShortTiming or nature of the diagnosis
                                                Comments

                                                For example: admitting, primary, secondary, discharge.

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

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

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

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

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

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

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

                                                Present on admission.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

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

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

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

                                                ShortPackage billing code
                                                Comments

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

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

                                                The DRG codes associated with the diagnosis.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

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

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

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

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

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

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

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                226. Claim.procedure.extension
                                                Definition

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

                                                ShortAdditional content defined by implementations
                                                Comments

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

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

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

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

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

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

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

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

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

                                                A number to uniquely identify procedure entries.

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

                                                Necessary to provide a mechanism to link to claim details.

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

                                                When the condition was observed or the relative ranking.

                                                ShortCategory of Procedure
                                                Comments

                                                For example: primary, secondary.

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

                                                Example procedure type codes.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

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

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

                                                Date and optionally time the procedure was performed.

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

                                                Required for auditing purposes.

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

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

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

                                                Example ICD10 Procedure codes.

                                                TypeChoice of: CodeableConcept, Reference(Procedure)
                                                [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

                                                This identifies the actual clinical procedure.

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

                                                Unique Device Identifiers associated with this line item.

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

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

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

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

                                                ShortPatient insurance information
                                                Comments

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

                                                Control1..*
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Summarytrue
                                                Requirements

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

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

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                244. Claim.insurance.extension
                                                Definition

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

                                                ShortAdditional content defined by implementations
                                                Comments

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

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

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

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

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

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

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

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

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

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

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

                                                To maintain order of the coverages.

                                                Pattern Value1
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                250. Claim.insurance.focal
                                                Definition

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

                                                ShortCoverage to be used for adjudication
                                                Comments

                                                A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies.

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

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

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

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

                                                ShortPre-assigned Claim number
                                                Comments

                                                Only required in jurisdictions where insurers, rather than the provider, are required to send claims to insurers that appear after them in the list. This element is not required when 'subrogation=true'.

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

                                                This will be the claim number should it be necessary to create this claim in the future. This is provided so that payors may forward claims to other payors in the Coordination of Benefit for adjudication rather than the provider being required to initiate each adjudication.

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

                                                Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.

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

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

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

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

                                                ShortUnique id for inter-element referencing
                                                Control0..1
                                                Typestring
                                                Is Modifierfalse
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Summaryfalse
                                                258. Claim.insurance.coverage.extension
                                                Definition

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

                                                ShortAdditional content defined by implementations
                                                Comments

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

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

                                                  A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                  ShortLiteral reference, Relative, internal or absolute URL
                                                  Comments

                                                  Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                  Control0..1
                                                  This element is affected by the following invariants: ref-1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  262. Claim.insurance.coverage.type
                                                  Definition

                                                  The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                                                  The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                                                  ShortType the reference refers to (e.g. "Patient")
                                                  Comments

                                                  This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                                                  Control0..1
                                                  BindingUnless not suitable, these codes SHALL be taken from ResourceType
                                                  (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                                                  Aa resource (or, for logical models, the URI of the logical model).

                                                  Typeuri
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  264. Claim.insurance.coverage.identifier
                                                  Definition

                                                  An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                  ShortLogical reference, when literal reference is not known
                                                  Comments

                                                  When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                  When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                  Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                  Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                  Control0..1
                                                  TypeIdentifier
                                                  Is Modifierfalse
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  266. Claim.insurance.coverage.display
                                                  Definition

                                                  Plain text narrative that identifies the resource in addition to the resource reference.

                                                  ShortText alternative for the resource
                                                  Comments

                                                  This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Pattern Valueuse of mandatory insurance coverage, no further details provided here.
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  268. Claim.insurance.businessArrangement
                                                  Definition

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

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

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

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

                                                  Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.

                                                  ShortPrior authorization reference number
                                                  Comments

                                                  This value is an alphanumeric string that may be provided over the phone, via text, via paper, or within a ClaimResponse resource and is not a FHIR Identifier.

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

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

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

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

                                                  ShortAdjudication results
                                                  Comments

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

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

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

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

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

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

                                                  When healthcare products and services are accident related, benefits may be payable under accident provisions of policies, such as automotive, etc before they are payable under normal health insurance.

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

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

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  278. Claim.accident.extension
                                                  Definition

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

                                                  ShortAdditional content defined by implementations
                                                  Comments

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

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

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

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

                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                  Comments

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

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

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

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

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

                                                  ShortWhen the incident occurred
                                                  Comments

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

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

                                                  Required for audit purposes and adjudication.

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

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

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

                                                  Type of accident: work place, auto, etc.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Coverage may be dependant on the type of accident.

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

                                                  The physical location of the accident event.

                                                  ShortWhere the event occurred
                                                  Control0..1
                                                  TypeChoice of: Address, Reference(Location)
                                                  [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Required for audit purposes and determination of applicable insurance liability.

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

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

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

                                                  The items to be processed for adjudication.

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

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

                                                  ShortUnique id for inter-element referencing
                                                  Control0..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  292. Claim.item.extension
                                                  Definition

                                                  An Extension

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

                                                    Data from the Belgian eID

                                                    ShortBeExtPatientIdentityDocument
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(BeExtPatientIdentityDocument) (Complex Extension)
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    296. Claim.item.extension:preAuthRef
                                                    Slice NamepreAuthRef
                                                    Definition

                                                    Optional Extension Element - found in all resources.

                                                    ShortOptional Extensions Element
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(BeExtEAttestationItemPreAuthRef) (Extension Type: string)
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    298. Claim.item.extension:supplement
                                                    Slice Namesupplement
                                                    Definition

                                                    Optional Extension Element - found in all resources.

                                                    ShortOptional Extensions Element
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(BeExtEAttestationItemSupplement) (Extension Type: Money)
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    300. Claim.item.modifierExtension
                                                    Definition

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

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

                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                    Comments

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

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

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

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

                                                    A number to uniquely identify item entries.

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

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

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

                                                    CareTeam members related to this service or product.

                                                    ShortApplicable careTeam members
                                                    Control1..*
                                                    TypepositiveInt
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    Summaryfalse
                                                    Requirements

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

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

                                                    Diagnosis applicable for this service or product.

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

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

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

                                                    Procedures applicable for this service or product.

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

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

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

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

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

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

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

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

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

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

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Needed in the processing of institutional claims.

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

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

                                                    ShortBenefit classification
                                                    Comments

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

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

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

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Requirements

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

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

                                                    When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.

                                                    ShortBilling, service, product, or drug code
                                                    Comments

                                                    If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                    Control1..1
                                                    BindingFor example codes, see USCLSCodes
                                                    (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                    Allowable service and product codes.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Summaryfalse
                                                    Requirements

                                                    Necessary to state what was provided or done.

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

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

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    320. Claim.item.productOrService.extension
                                                    Definition

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

                                                    ShortAdditional content defined by implementations
                                                    Comments

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

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

                                                      A reference to a code defined by a terminology system.

                                                      ShortCode defined by a terminology system
                                                      Comments

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

                                                      Control1..1
                                                      TypeCoding
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Requirements

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

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

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

                                                      ShortUnique id for inter-element referencing
                                                      Control0..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Summaryfalse
                                                      326. Claim.item.productOrService.coding.extension
                                                      Definition

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

                                                      ShortAdditional content defined by implementations
                                                      Comments

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

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

                                                        The identification of the code system that defines the meaning of the symbol in the code.

                                                        ShortIdentity of the terminology system
                                                        Comments

                                                        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

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

                                                        Need to be unambiguous about the source of the definition of the symbol.

                                                        Pattern Valuehttps://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        330. Claim.item.productOrService.coding.version
                                                        Definition

                                                        The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                                        ShortVersion of the system - if relevant
                                                        Comments

                                                        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                                        NoteThis is a business versionId, not a resource version id (see discussion)
                                                        Control0..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        332. Claim.item.productOrService.coding.code
                                                        Definition

                                                        A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                                        ShortSymbol in syntax defined by the system
                                                        Control1..1
                                                        Typecode
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summarytrue
                                                        Requirements

                                                        Need to refer to a particular code in the system.

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

                                                        A representation of the meaning of the code in the system, following the rules of the system.

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

                                                        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

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

                                                        Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                                        ShortIf this coding was chosen directly by the user
                                                        Comments

                                                        Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

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

                                                        This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

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

                                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                        ShortPlain text representation of the concept
                                                        Comments

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

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

                                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

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

                                                        ShortProduct or service billing modifiers
                                                        Comments

                                                        For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.

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

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

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

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

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

                                                        Identifies the program under which this may be recovered.

                                                        ShortProgram the product or service is provided under
                                                        Comments

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

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

                                                        Program specific reason codes.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

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

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

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

                                                        ShortDate or dates of service or product delivery
                                                        Control1..1
                                                        Typedate
                                                        [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summaryfalse
                                                        Requirements

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

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        SlicingThis element introduces a set of slices on Claim.item.serviced[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
                                                        • type @ $this
                                                        • 346. Claim.item.serviced[x]:servicedDate
                                                          Slice NameservicedDate
                                                          Definition

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

                                                          ShortDate or dates of service or product delivery
                                                          Control1..1
                                                          Typedate
                                                          [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Requirements

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

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

                                                          Where the product or service was provided.

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

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

                                                          TypeChoice of: CodeableConcept, Address, Reference(Location)
                                                          [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Requirements

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

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          SlicingThis element introduces a set of slices on Claim.item.location[x]. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                          • type @ $this
                                                          • 350. Claim.item.location[x]:locationReference
                                                            Slice NamelocationReference
                                                            Definition

                                                            Where the product or service was provided.

                                                            ShortPlace of service or where product was supplied
                                                            Control0..1
                                                            TypeReference(Location)
                                                            [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Summaryfalse
                                                            Requirements

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

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

                                                            The number of repetitions of a service or product.

                                                            ShortCount of products or services
                                                            Control1..1
                                                            TypeQuantity(SimpleQuantity)
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Summaryfalse
                                                            Requirements

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

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

                                                            If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

                                                            ShortFee, charge or cost per item
                                                            Control1..1
                                                            TypeMoney
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Summaryfalse
                                                            Requirements

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

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

                                                            A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                            ShortPrice scaling factor
                                                            Comments

                                                            To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

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

                                                            When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

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

                                                            The quantity times the unit price for an additional service or product or charge.

                                                            ShortTotal item cost
                                                            Comments

                                                            For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                            Control1..1
                                                            TypeMoney
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Summaryfalse
                                                            Requirements

                                                            Provides the total amount claimed for the group (if a grouper) or the line item.

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

                                                            Unique Device Identifiers associated with this line item.

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

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

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

                                                            Physical service site on the patient (limb, tooth, etc.).

                                                            ShortAnatomical location
                                                            Comments

                                                            For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.

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

                                                            The code for the teeth, quadrant, sextant and arch.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Summaryfalse
                                                            Requirements

                                                            Allows insurer to validate specific procedures.

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

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

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Summaryfalse
                                                            366. Claim.item.bodySite.extension
                                                            Definition

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

                                                            ShortAdditional content defined by implementations
                                                            Comments

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

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

                                                              An explicit statement of laterality of a lesion, or a treatment, etc.

                                                              ShortBeExtLaterality
                                                              Control0..1
                                                              TypeExtension(BeExtLaterality) (Extension Type: Coding)
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              370. Claim.item.bodySite.extension:bodyLaterality.id
                                                              Definition

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

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              Typestring
                                                              Is Modifierfalse
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              Summaryfalse
                                                              372. Claim.item.bodySite.extension:bodyLaterality.extension
                                                              Definition

                                                              An Extension

                                                              ShortExtension
                                                              Control0..0
                                                              TypeExtension
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              SlicingThis element introduces a set of slices on Claim.item.bodySite.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 374. Claim.item.bodySite.extension:bodyLaterality.url
                                                                Definition

                                                                Source of the definition for the extension code - a logical name or a URL.

                                                                Shortidentifies the meaning of the extension
                                                                Comments

                                                                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                Control1..1
                                                                Typeuri
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                Fixed Valuehttps://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality
                                                                376. Claim.item.bodySite.extension:bodyLaterality.value[x]
                                                                Definition

                                                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                ShortValue of extension
                                                                Control0..1
                                                                BindingThe codes SHALL be taken from Basic Laterality
                                                                (required to https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-basic-laterality)
                                                                TypeCoding
                                                                [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                378. Claim.item.bodySite.coding
                                                                Definition

                                                                A reference to a code defined by a terminology system.

                                                                ShortCode defined by a terminology system
                                                                Comments

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

                                                                Control0..*
                                                                BindingThe codes SHALL be taken from Body Site
                                                                (required to https://www.ehealth.fgov.be/standards/fhir/core-clinical/ValueSet/be-vs-bodysite)
                                                                TypeCoding
                                                                Is Modifierfalse
                                                                Summarytrue
                                                                Requirements

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

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

                                                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                ShortPlain text representation of the concept
                                                                Comments

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

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

                                                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

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

                                                                A region or surface of the bodySite, e.g. limb region or tooth surface(s).

                                                                ShortAnatomical sub-location
                                                                Control0..*
                                                                BindingFor example codes, see SurfaceCodes
                                                                (example to http://hl7.org/fhir/ValueSet/surface)

                                                                The code for the tooth surface and surface combinations.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Allows insurer to validate specific procedures.

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

                                                                The Encounters during which this Claim was created or to which the creation of this record is tightly associated.

                                                                ShortEncounters related to this billed item
                                                                Comments

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

                                                                Control0..*
                                                                TypeReference(Encounter)
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

                                                                A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

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

                                                                The items to be processed for adjudication.

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

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

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                390. Claim.item.detail.extension
                                                                Definition

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

                                                                ShortAdditional content defined by implementations
                                                                Comments

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

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

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

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

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

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

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

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

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

                                                                A number to uniquely identify item entries.

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

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

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

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

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

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

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Needed in the processing of institutional claims.

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

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

                                                                ShortBenefit classification
                                                                Comments

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

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

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

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

                                                                When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.

                                                                ShortBilling, service, product, or drug code
                                                                Comments

                                                                If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                                Control1..1
                                                                BindingFor example codes, see USCLSCodes
                                                                (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                                Allowable service and product codes.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Necessary to state what was provided or done.

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

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

                                                                ShortService/Product billing modifiers
                                                                Comments

                                                                For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

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

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

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

                                                                Identifies the program under which this may be recovered.

                                                                ShortProgram the product or service is provided under
                                                                Comments

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

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

                                                                Program specific reason codes.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

                                                                The number of repetitions of a service or product.

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

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

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

                                                                If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

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

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

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

                                                                A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                                ShortPrice scaling factor
                                                                Comments

                                                                To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

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

                                                                When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

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

                                                                The quantity times the unit price for an additional service or product or charge.

                                                                ShortTotal item cost
                                                                Comments

                                                                For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                Control0..1
                                                                TypeMoney
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Provides the total amount claimed for the group (if a grouper) or the line item.

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

                                                                Unique Device Identifiers associated with this line item.

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

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

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

                                                                A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.

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

                                                                The items to be processed for adjudication.

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

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

                                                                ShortUnique id for inter-element referencing
                                                                Control0..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                Summaryfalse
                                                                420. Claim.item.detail.subDetail.extension
                                                                Definition

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

                                                                ShortAdditional content defined by implementations
                                                                Comments

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

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

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

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

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

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

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

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

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

                                                                A number to uniquely identify item entries.

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

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

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

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

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

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

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Needed in the processing of institutional claims.

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

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

                                                                ShortBenefit classification
                                                                Comments

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

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

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

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

                                                                When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.

                                                                ShortBilling, service, product, or drug code
                                                                Comments

                                                                If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.

                                                                Control1..1
                                                                BindingFor example codes, see USCLSCodes
                                                                (example to http://hl7.org/fhir/ValueSet/service-uscls)

                                                                Allowable service and product codes.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Necessary to state what was provided or done.

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

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

                                                                ShortService/Product billing modifiers
                                                                Comments

                                                                For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.

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

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

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

                                                                Identifies the program under which this may be recovered.

                                                                ShortProgram the product or service is provided under
                                                                Comments

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

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

                                                                Program specific reason codes.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

                                                                The number of repetitions of a service or product.

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

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

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

                                                                If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

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

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

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

                                                                A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

                                                                ShortPrice scaling factor
                                                                Comments

                                                                To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).

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

                                                                When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.

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

                                                                The quantity times the unit price for an additional service or product or charge.

                                                                ShortTotal item cost
                                                                Comments

                                                                For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.

                                                                Control0..1
                                                                TypeMoney
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Provides the total amount claimed for the group (if a grouper) or the line item.

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

                                                                Unique Device Identifiers associated with this line item.

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

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

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

                                                                The total value of the all the items in the claim.

                                                                ShortTotal claim cost
                                                                Control0..1
                                                                TypeMoney
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Requirements

                                                                Used for control total purposes.

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