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Patient Administration icon Work GroupMaturity Level: 1 Trial UseSecurity Category: Business Compartments: No defined compartments

Detailed Descriptions for the elements in the ChargeItemDefinition resource.

ChargeItemDefinition
Element Id ChargeItemDefinition
Definition

The ChargeItemDefinition resource provides the properties that apply to the (billing) codes necessary to calculate costs and prices. The properties may differ largely depending on type and realm, therefore this resource gives only a rough structure and requires profiling for each type of billing code system.

Short Display Definition of properties and rules about how the price and the applicability of a ChargeItem can be determined
Cardinality 0..*
Type MetadataResource
Summary false
Invariants
Defined on this element
cnl-0Warning Name should be usable as an identifier for the module by machine processing applications such as code generationname.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$')
ChargeItemDefinition.url
Element Id ChargeItemDefinition.url
Definition

An absolute URI that is used to identify this charge item definition when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this charge item definition is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the charge item definition is stored on different servers.

Short Display Canonical identifier for this charge item definition, represented as a URI (globally unique)
Cardinality 0..1
Type uri
Requirements

Allows the charge item definition to be referenced by a single globally unique identifier.

Summary true
Comments

Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

Invariants
Defined on this element
cnl-1Warning URL should not contain | or # - these characters make processing canonical references problematicexists() implies matches('^[^|# ]+$')
ChargeItemDefinition.identifier
Element Id ChargeItemDefinition.identifier
Definition

A formal identifier that is used to identify this charge item definition when it is represented in other formats, or referenced in a specification, model, design or an instance.

Short Display Additional identifier for the charge item definition
Note This is a business identifier, not a resource identifier (see discussion)
Cardinality 0..*
Type Identifier
Requirements

Allows externally provided and/or usable business identifiers to be easily associated with the module.

Summary true
Comments

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this charge item definition outside of FHIR, where it is not possible to use the logical URI.

ChargeItemDefinition.version
Element Id ChargeItemDefinition.version
Definition

The identifier that is used to identify this version of the charge item definition when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the charge item definition author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active assets.

Short Display Business version of the charge item definition
Note This is a business versionId, not a resource version id (see discussion)
Cardinality 0..1
Type string
Summary true
Comments

There may be different charge item definition instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the charge item definition with the format [url]|[version]. The version SHOULD NOT contain a '#' - see Business Version.

ChargeItemDefinition.versionAlgorithm[x]
Element Id ChargeItemDefinition.versionAlgorithm[x]
Definition

Indicates the mechanism used to compare versions to determine which is more current.

Short Display How to compare versions
Cardinality 0..1
Terminology Binding Version Algorithm (Extensible)
Type string|Coding
[x] Note See Choice of Datatypes for further information about how to use [x]
Summary true
Comments

If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

ChargeItemDefinition.name
Element Id ChargeItemDefinition.name
Definition

A natural language name identifying the ChargeItemDefinition. This name should be usable as an identifier for the module by machine processing applications such as code generation.

Short Display Name for this charge item definition (computer friendly)
Cardinality 0..1
Type string
Requirements

Support human navigation and code generation.

Summary true
Comments

The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

Invariants
Affect this element
cnl-0Warning Name should be usable as an identifier for the module by machine processing applications such as code generationname.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$')
ChargeItemDefinition.title
Element Id ChargeItemDefinition.title
Definition

A short, descriptive, user-friendly title for the charge item definition.

Short Display Name for this charge item definition (human friendly)
Cardinality 0..1
Type string
Summary true
Comments

This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

ChargeItemDefinition.derivedFromUri
Element Id ChargeItemDefinition.derivedFromUri
Definition

The URL pointing to an externally-defined charge item definition that is adhered to in whole or in part by this definition.

Short Display Underlying externally-defined charge item definition
Cardinality 0..*
Type uri
Summary true
ChargeItemDefinition.partOf
Element Id ChargeItemDefinition.partOf
Definition

A larger definition of which this particular definition is a component or step.

Short Display A larger definition of which this particular definition is a component or step
Cardinality 0..*
Type canonical(ChargeItemDefinition)
Hierarchy This reference is part of a strict Hierarchy
Alternate Names container
Summary true
ChargeItemDefinition.replaces
Element Id ChargeItemDefinition.replaces
Definition

As new versions of a protocol or guideline are defined, allows identification of what versions are replaced by a new instance.

Short Display Completed or terminated request(s) whose function is taken by this new request
Cardinality 0..*
Type canonical(ChargeItemDefinition)
Alternate Names supersedes; prior; renewed order
Summary true
ChargeItemDefinition.status
Element Id ChargeItemDefinition.status
Definition

The current state of the ChargeItemDefinition.

Short Display draft | active | retired | unknown
Cardinality 1..1
Terminology Binding PublicationStatus (Required)
Type code
Is Modifier true (Reason: This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration)
Summary true
Comments

Allows filtering of charge item definitions that are appropriate for use versus not.

See guidance around (not) making local changes to elements here.

ChargeItemDefinition.experimental
Element Id ChargeItemDefinition.experimental
Definition

A Boolean value to indicate that this charge item definition is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

Short Display For testing purposes, not real usage
Cardinality 0..1
Type boolean
Meaning if Missing If absent, this resource is treated as though it is not experimental.
Requirements

Enables experimental content to be developed following the same lifecycle that would be used for a production-level charge item definition.

Summary true
Comments

Allows filtering of charge item definitions that are appropriate for use versus not.

ChargeItemDefinition.date
Element Id ChargeItemDefinition.date
Definition

The date (and optionally time) when the charge item definition was last significantly changed. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the charge item definition changes.

Short Display Date last changed
Cardinality 0..1
Type dateTime
Alternate Names Revision Date
Summary true
Comments

The date is often not tracked until the resource is published, but may be present on draft content. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the charge item definition. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

See guidance around (not) making local changes to elements here.

ChargeItemDefinition.account
Element Id ChargeItemDefinition.account
Definition

A set of candidate accounts to which charge items using this definition may be assigned.

Short Display Candidate account(s) for charge items
Cardinality 0..*
Type Reference(Account)
Summary true
Comments

An Account resource may represent either a patient-oriented account or an organizational account (e.g., a cost center). This property is intended for use with the cost center style accounts, and is not expected to refer to patient-oriented accounts. For example, if a ChargeItemDefinition is created to bill for a research procedure, this property could indicate that all charges for that procedure could be directed to the specified account.

ChargeItemDefinition.publisher
Element Id ChargeItemDefinition.publisher
Definition

The name of the organization or individual responsible for the release and ongoing maintenance of the charge item definition.

Short Display Name of the publisher/steward (organization or individual)
Cardinality 0..1
Type string
Requirements

Helps establish the "authority/credibility" of the charge item definition. May also allow for contact.

Summary true
Comments

Usually an organization but may be an individual. The publisher (or steward) of the charge item definition is the organization or individual primarily responsible for the maintenance and upkeep of the charge item definition. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the charge item definition. This item SHOULD be populated unless the information is available from context.

ChargeItemDefinition.contact
Element Id ChargeItemDefinition.contact
Definition

Contact details to assist a user in finding and communicating with the publisher.

Short Display Contact details for the publisher
Cardinality 0..*
Type ContactDetail
Summary true
Comments

May be a web site, an email address, a telephone number, etc.

See guidance around (not) making local changes to elements here.

ChargeItemDefinition.description
Element Id ChargeItemDefinition.description
Definition

A free text natural language description of the charge item definition from a consumer's perspective.

Short Display Natural language description of the charge item definition
Cardinality 0..1
Type markdown
Summary true
Comments

This description can be used to capture details such as comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the charge item definition as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the charge item definition is presumed to be the predominant language in the place the charge item definition was created).

ChargeItemDefinition.useContext
Element Id ChargeItemDefinition.useContext
Definition

The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate charge item definition instances.

Short Display The context that the content is intended to support
Cardinality 0..*
Type UsageContext
Requirements

Assist in searching for appropriate content.

Summary true
Comments

When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

ChargeItemDefinition.jurisdiction
Standards Status This element has a standards status of "Deprecated" which is different from the status of the whole resource
Element Id ChargeItemDefinition.jurisdiction
Definition

A legal or geographic region in which the charge item definition is intended to be used.

Short Display Intended jurisdiction for charge item definition (if applicable)
Cardinality 0..*
Terminology Binding Jurisdiction ValueSet (Extensible)
Type CodeableConcept
Summary true
Comments

It may be possible for the charge item definition to be used in jurisdictions other than those for which it was originally designed or intended.

DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'jurisdiction' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#jurisdiction and useContext.valueCodeableConcept indicating the jurisdiction.)

ChargeItemDefinition.purpose
Element Id ChargeItemDefinition.purpose
Definition

Explanation of why this charge item definition is needed and why it has been designed as it has.

Short Display Why this charge item definition is defined
Cardinality 0..1
Type markdown
Summary false
Comments

This element does not describe the usage of the charge item definition. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this charge item definition.

ChargeItemDefinition.copyright
Element Id ChargeItemDefinition.copyright
Definition

A copyright statement relating to the charge item definition and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the charge item definition.

Short Display Use and/or publishing restrictions
Cardinality 0..1
Type markdown
Requirements

Consumers must be able to determine any legal restrictions on the use of the charge item definition and/or its content.

Alternate Names License; Restrictions
Summary false
ChargeItemDefinition.copyrightLabel
Element Id ChargeItemDefinition.copyrightLabel
Definition

A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved').

Short Display Copyright holder and year(s)
Cardinality 0..1
Type string
Requirements

Defines the content expected to be rendered in all representations of the artifact.

Summary false
Comments

The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

ChargeItemDefinition.approvalDate
Element Id ChargeItemDefinition.approvalDate
Definition

The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

Short Display When the charge item definition was approved by publisher
Cardinality 0..1
Type date
Summary false
Comments

The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

See guidance around (not) making local changes to elements here.

ChargeItemDefinition.lastReviewDate
Element Id ChargeItemDefinition.lastReviewDate
Definition

The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

Short Display When the charge item definition was last reviewed by the publisher
Cardinality 0..1
Type date
Requirements

Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

Summary false
Comments

If specified, this date follows the original approval date.

See guidance around (not) making local changes to elements here.

ChargeItemDefinition.code
Element Id ChargeItemDefinition.code
Definition

The defined billing details in this resource pertain to the given billing code.

Short Display Billing code or product type this definition applies to
Cardinality 0..1
Terminology Binding Charge Item Code (Example)
Type CodeableConcept
Summary true
ChargeItemDefinition.instance
Element Id ChargeItemDefinition.instance
Definition

The defined billing details in this resource pertain to the given product instance(s).

Short Display Instances this definition applies to
Cardinality 0..*
Type Reference(Medication | Substance | Device | DeviceDefinition | ActivityDefinition | PlanDefinition | HealthcareService)
Summary false
Comments

In case of highly customized, individually produced or fitted devices/substances, the pricing information may be different for each instance of the product. This reference links pricing details to specific product instances.

ChargeItemDefinition.applicability
Element Id ChargeItemDefinition.applicability
Definition

Expressions that describe applicability criteria for the billing code.

Short Display Whether or not the billing code is applicable
Cardinality 0..*
Summary false
Comments

The applicability conditions can be used to ascertain whether a billing item is allowed in a specific context. E.g. some billing codes may only be applicable in out-patient settings, only to male/female patients or only to children.

ChargeItemDefinition.applicability.condition
Element Id ChargeItemDefinition.applicability.condition
Definition

An expression that returns true or false, indicating whether the condition is satisfied. When using FHIRPath expressions, the %context environment variable must be replaced at runtime with the ChargeItem resource to which this definition is applied.

Short Display Boolean-valued expression
Cardinality 0..1
Type Expression
Summary false
Comments

Please note that FHIRPath Expressions can only be evaluated in the scope of the current ChargeItem resource to which this definition is being applied. FHIRPath expressions can traverse into other resources linked from the ChargeItem resource, however, testing rules such as that a billing code may be billed only once per encounter need a wider scope. In such scenarios, CQL may be the appropriate choice.

ChargeItemDefinition.applicability.effectivePeriod
Element Id ChargeItemDefinition.applicability.effectivePeriod
Definition

The period during which the charge item definition content was or is planned to be in active use.

Short Display When the charge item definition is expected to be used
Cardinality 0..1
Type Period
Requirements

Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the charge item definition are or are expected to be used instead.

Summary true
Comments

The effective period for a charge item definition determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

ChargeItemDefinition.applicability.relatedArtifact
Element Id ChargeItemDefinition.applicability.relatedArtifact
Definition

Reference to / quotation of the external source of the group of properties.

Short Display Reference to / quotation of the external source of the group of properties
Cardinality 0..1
Type RelatedArtifact
Summary false
ChargeItemDefinition.propertyGroup
Element Id ChargeItemDefinition.propertyGroup
Definition

Group of properties which are applicable under the same conditions. If no applicability rules are established for the group, then all properties always apply.

Short Display Group of properties which are applicable under the same conditions
Cardinality 0..*
Summary false
ChargeItemDefinition.propertyGroup.applicability
Element Id ChargeItemDefinition.propertyGroup.applicability
Definition

Expressions that describe applicability criteria for the priceComponent.

Short Display Conditions under which the priceComponent is applicable
Cardinality 0..*
Type See ChargeItemDefinition.applicability
Summary false
Comments

The applicability conditions can be used to ascertain whether a billing item is allowed in a specific context. E.g. some billing codes may only be applicable in out-patient settings, only to male/female patients or only to children.

ChargeItemDefinition.propertyGroup.priceComponent
Element Id ChargeItemDefinition.propertyGroup.priceComponent
Definition

The price for a ChargeItem may be calculated as a base price with surcharges/deductions that apply in certain conditions. A ChargeItemDefinition resource that defines the prices, factors and conditions that apply to a billing code is currently under development. The priceComponent element can be used to offer transparency to the recipient of the Invoice of how the prices have been calculated.

Short Display Components of total line item price
Cardinality 0..*
Type MonetaryComponent
Summary false