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8.29 Resource ChargeItemDefinition - Content

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

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.



8.29.1 Scope and Usage

The ChargeItemDefinition holds all relevant billing information pertaining to a billing code or a product.

Many billing systems have rules associated with the code which may define whether a billing code is applicable in a specific context or whether certain billing details (surcharges, discounts) apply. ChargeItemDefinitions may also be used to hold pricing information pertaining to only one specific instance of a product (e.g. Device, Medication or Substance) which may be a requirement for custom made devices or medications or other products where prices vary by instance. Rules for applicability may include

  • a billing code is only applicable in an outpatient setting
  • a surcharge that applies only to services provided outside regular business hours
  • a discount that applies only to patients up to the age of 14
  • a billing code that may only be charged once per Encounter
  • a billing code that can only be charged in combination with another code from the same billing system

A billing engine will apply the ChargeItemDefinitions to all ChargeItems within a specific Account in order to select all billable items an acquire the pricing details to create an Invoice. However, ChargeItems may be validated against a ChargeItemDefinition at any point in time, using the $apply-Operation

8.29.2 Boundaries and Relationships

While the ChargeItem resource represents the occurrence of a billing code (for services rendered or products supplied to a specific patient), the ChargeItemDefinition represents the properties and rules that a billing engine needs to determine the pricing and applicability of a billing code in the context of a specific setting.

Billing Codes may be defined in a CodeSystem Resource, however, each of these codes - if it is used in a financial context - can have a large number of business rules and properties associated with it, that lay outside the scope of CodeSystem and may change in time independently from the underlying Code's validity period. Even though CodeSystem can associate a concept with any number of additional properties, such a construct would be very hard to maintain. This is why the ChargItemDefinition has been introduced. It allows to maintain the attributes of each billing code independently and has a wider scope to also include business rules.

In most use cases, billing codes will be both defined as semantical concepts in a CodeSystem and as a financial artifact in ChargeItemDefinition.

ChargeItemDefinitions that pertain to codes from the same CodeSystem may be aggregated using the Catalog profile for Composition.

Resources representing products that can be sold or billed (Device, Medication, Substance...), do not specify financial details for the product instance. Most of the time, such products are not billed seperately but are a part of a generic billing code that covers both the product and the service rendered. In some occasions however, product prices may vary depending on type or manufactuer or even on instance (e.g. custom made products). For these cases, ChargeItemDefinitions may be created to specify the financial details for a product kind, type or instance.

8.29.3 References to this Resource

8.29.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ChargeItemDefinition TU DomainResource Definition of properties and rules about how the price and the applicability of a ChargeItem can be determined
+ Warning: Name should be usable as an identifier for the module by machine processing applications such as code generation

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
Interfaces Implemented: MetadataResource
... url ΣC 0..1 uri Canonical identifier for this charge item definition, represented as a URI (globally unique)
+ Warning: URL should not contain | or # - these characters make processing canonical references problematic
... identifier Σ 0..* Identifier Additional identifier for the charge item definition

... version Σ 0..1 string Business version of the charge item definition
... versionAlgorithm[x] Σ 0..1 How to compare versions
Binding: Version Algorithm (Extensible)
.... versionAlgorithmString string
.... versionAlgorithmCoding Coding
... name ΣC 0..1 string Name for this charge item definition (computer friendly)
... title ΣT 0..1 string Name for this charge item definition (human friendly)
... derivedFromUri Σ 0..* uri Underlying externally-defined charge item definition

... partOf Σ 0..* canonical(ChargeItemDefinition) A larger definition of which this particular definition is a component or step

... replaces Σ 0..* canonical(ChargeItemDefinition) Completed or terminated request(s) whose function is taken by this new request

... status ?!Σ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus (Required)
... experimental Σ 0..1 boolean For testing purposes, not real usage
... date Σ 0..1 dateTime Date last changed
... account Σ 0..* Reference(Account) Candidate account(s) for charge items

... publisher ΣT 0..1 string Name of the publisher/steward (organization or individual)
... contact Σ 0..* ContactDetail Contact details for the publisher

... description ΣT 0..1 markdown Natural language description of the charge item definition
... useContext Σ 0..* UsageContext The context that the content is intended to support

... jurisdiction ΣXD 0..* CodeableConcept Intended jurisdiction for charge item definition (if applicable)
Binding: Jurisdiction ValueSet (Extensible)

... purpose T 0..1 markdown Why this charge item definition is defined
... copyright T 0..1 markdown Use and/or publishing restrictions
... copyrightLabel T 0..1 string Copyright holder and year(s)
... approvalDate 0..1 date When the charge item definition was approved by publisher
... lastReviewDate 0..1 date When the charge item definition was last reviewed by the publisher
... code Σ 0..1 CodeableConcept Billing code or product type this definition applies to
Binding: Charge Item Code (Example)
... instance 0..* Reference(Medication | Substance | Device | DeviceDefinition | ActivityDefinition | PlanDefinition | HealthcareService) Instances this definition applies to

... applicability 0..* BackboneElement Whether or not the billing code is applicable

.... condition 0..1 Expression Boolean-valued expression
.... effectivePeriod Σ 0..1 Period When the charge item definition is expected to be used
.... relatedArtifact 0..1 RelatedArtifact Reference to / quotation of the external source of the group of properties
... propertyGroup 0..* BackboneElement Group of properties which are applicable under the same conditions

.... applicability 0..* see applicability Conditions under which the priceComponent is applicable

.... priceComponent 0..* MonetaryComponent Components of total line item price


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

ChargeItemDefinition (DomainResource) +MetadataResourceAn 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 serversurl : uri [0..1]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 instanceidentifier : Identifier [0..*]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 assetsversion : string [0..1]Indicates the mechanism used to compare versions to determine which is more currentversionAlgorithm[x] : DataType [0..1] « string|Coding; null (Strength=Extensible) VersionAlgorithm+ »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 generationname : string [0..1] « This element has or is affected by some invariantsC »A short, descriptive, user-friendly title for the charge item definitiontitle : string [0..1]The URL pointing to an externally-defined charge item definition that is adhered to in whole or in part by this definitionderivedFromUri : uri [0..*]A larger definition of which this particular definition is a component or steppartOf : canonical [0..*] « ChargeItemDefinition »As new versions of a protocol or guideline are defined, allows identification of what versions are replaced by a new instancereplaces : canonical [0..*] « ChargeItemDefinition »The current state of the ChargeItemDefinition (this element modifies the meaning of other elements)status : code [1..1] « null (Strength=Required)PublicationStatus! »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 usageexperimental : boolean [0..1]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 changesdate : dateTime [0..1] A set of candidate accounts to which charge items using this definition may be assignedaccount : Reference [0..*] « Account »The name of the organization or individual responsible for the release and ongoing maintenance of the charge item definitionpublisher : string [0..1]Contact details to assist a user in finding and communicating with the publishercontact : ContactDetail [0..*]A free text natural language description of the charge item definition from a consumer's perspectivedescription : markdown [0..1]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 instancesuseContext : UsageContext [0..*]A legal or geographic region in which the charge item definition is intended to be usedjurisdiction : CodeableConcept [0..*] « null (Strength=Extensible)JurisdictionValueSet+ »Explanation of why this charge item definition is needed and why it has been designed as it haspurpose : markdown [0..1]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 definitioncopyright : markdown [0..1]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')copyrightLabel : string [0..1]The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usageapprovalDate : date [0..1]The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval datelastReviewDate : date [0..1]The defined billing details in this resource pertain to the given billing codecode : CodeableConcept [0..1] « null (Strength=Example)ChargeItemCode?? »The defined billing details in this resource pertain to the given product instance(s)instance : Reference [0..*] « Medication|Substance|Device| DeviceDefinition|ActivityDefinition|PlanDefinition| HealthcareService »ApplicabilityAn 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 appliedcondition : Expression [0..1]The period during which the charge item definition content was or is planned to be in active useeffectivePeriod : Period [0..1]Reference to / quotation of the external source of the group of propertiesrelatedArtifact : RelatedArtifact [0..1]PropertyGroupThe 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 calculatedpriceComponent : MonetaryComponent [0..*]Expressions that describe applicability criteria for the billing codeapplicability[0..*]Expressions that describe applicability criteria for the priceComponentapplicability[0..*]Group of properties which are applicable under the same conditions. If no applicability rules are established for the group, then all properties always applypropertyGroup[0..*]

XML Template

<ChargeItemDefinition xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Canonical identifier for this charge item definition, represented as a URI (globally unique) -->
 <identifier><!-- 0..* Identifier Additional identifier for the charge item definition --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of the charge item definition -->
 <versionAlgorithm[x]><!-- 0..1 string|Coding How to compare versions --></versionAlgorithm[x]>
 <name value="[string]"/><!-- I 0..1 Name for this charge item definition (computer friendly) -->
 <title value="[string]"/><!-- 0..1 Name for this charge item definition (human friendly) -->
 <derivedFromUri value="[uri]"/><!-- 0..* Underlying externally-defined charge item definition -->
 <partOf><!-- 0..* canonical(ChargeItemDefinition) A larger definition of which this particular definition is a component or step --></partOf>
 <replaces><!-- 0..* canonical(ChargeItemDefinition) Completed or terminated request(s) whose function is taken by this new request --></replaces>
 <status value="[code]"/><!-- 1..1 draft | active | retired | unknown -->
 <experimental value="[boolean]"/><!-- 0..1 For testing purposes, not real usage -->
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <account><!-- 0..* Reference(Account) Candidate account(s) for charge items --></account>
 <publisher value="[string]"/><!-- 0..1 Name of the publisher/steward (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <description value="[markdown]"/><!-- 0..1 Natural language description of the charge item definition -->
 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <jurisdiction><!-- 0..* CodeableConcept Intended jurisdiction for charge item definition (if applicable) --></jurisdiction>
 <purpose value="[markdown]"/><!-- 0..1 Why this charge item definition is defined -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <copyrightLabel value="[string]"/><!-- 0..1 Copyright holder and year(s) -->
 <approvalDate value="[date]"/><!-- 0..1 When the charge item definition was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the charge item definition was last reviewed by the publisher -->
 <code><!-- 0..1 CodeableConcept Billing code or product type this definition applies to --></code>
 <instance><!-- 0..* Reference(ActivityDefinition|Device|DeviceDefinition|
   HealthcareService|Medication|PlanDefinition|Substance) Instances this definition applies to --></instance>
 <applicability>  <!-- 0..* Whether or not the billing code is applicable -->
  <condition><!-- 0..1 Expression Boolean-valued expression --></condition>
  <effectivePeriod><!-- 0..1 Period When the charge item definition is expected to be used --></effectivePeriod>
  <relatedArtifact><!-- 0..1 RelatedArtifact Reference to / quotation of the external source of the group of properties --></relatedArtifact>
 </applicability>
 <propertyGroup>  <!-- 0..* Group of properties which are applicable under the same conditions -->
  <applicability><!-- 0..* Content as for ChargeItemDefinition.applicability Conditions under which the priceComponent is applicable --></applicability>
  <priceComponent><!-- 0..* MonetaryComponent Components of total line item price --></priceComponent>
 </propertyGroup>
</ChargeItemDefinition>

JSON Template

{doco
  "resourceType" : "ChargeItemDefinition",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Canonical identifier for this charge item definition, represented as a URI (globally unique)
  "identifier" : [{ Identifier }], // Additional identifier for the charge item definition
  "version" : "<string>", // Business version of the charge item definition
  // versionAlgorithm[x]: How to compare versions. One of these 2:
  "versionAlgorithmString" : "<string>",
  "versionAlgorithmCoding" : { Coding },
  "name" : "<string>", // I Name for this charge item definition (computer friendly)
  "title" : "<string>", // Name for this charge item definition (human friendly)
  "derivedFromUri" : ["<uri>"], // Underlying externally-defined charge item definition
  "partOf" : ["<canonical(ChargeItemDefinition)>"], // A larger definition of which this particular definition is a component or step
  "replaces" : ["<canonical(ChargeItemDefinition)>"], // Completed or terminated request(s) whose function is taken by this new request
  "status" : "<code>", // R!  draft | active | retired | unknown
  "experimental" : <boolean>, // For testing purposes, not real usage
  "date" : "<dateTime>", // Date last changed
  "account" : [{ Reference(Account) }], // Candidate account(s) for charge items
  "publisher" : "<string>", // Name of the publisher/steward (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "description" : "<markdown>", // Natural language description of the charge item definition
  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "jurisdiction" : [{ CodeableConcept }], // Intended jurisdiction for charge item definition (if applicable)
  "purpose" : "<markdown>", // Why this charge item definition is defined
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "copyrightLabel" : "<string>", // Copyright holder and year(s)
  "approvalDate" : "<date>", // When the charge item definition was approved by publisher
  "lastReviewDate" : "<date>", // When the charge item definition was last reviewed by the publisher
  "code" : { CodeableConcept }, // Billing code or product type this definition applies to
  "instance" : [{ Reference(ActivityDefinition|Device|DeviceDefinition|
   HealthcareService|Medication|PlanDefinition|Substance) }], // Instances this definition applies to
  "applicability" : [{ // Whether or not the billing code is applicable
    "condition" : { Expression }, // Boolean-valued expression
    "effectivePeriod" : { Period }, // When the charge item definition is expected to be used
    "relatedArtifact" : { RelatedArtifact } // Reference to / quotation of the external source of the group of properties
  }],
  "propertyGroup" : [{ // Group of properties which are applicable under the same conditions
    "applicability" : [{ Content as for ChargeItemDefinition.applicability }], // Conditions under which the priceComponent is applicable
    "priceComponent" : [{ MonetaryComponent }] // Components of total line item price
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:ChargeItemDefinition;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:url [ uri ] ; # 0..1 Canonical identifier for this charge item definition, represented as a URI (globally unique)
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Additional identifier for the charge item definition
  fhir:version [ string ] ; # 0..1 Business version of the charge item definition
  # versionAlgorithm[x] : 0..1 How to compare versions. One of these 2
    fhir:versionAlgorithm [  a fhir:string ; string ]
    fhir:versionAlgorithm [  a fhir:Coding ; Coding ]
  fhir:name [ string ] ; # 0..1 I Name for this charge item definition (computer friendly)
  fhir:title [ string ] ; # 0..1 Name for this charge item definition (human friendly)
  fhir:derivedFromUri  ( [ uri ] ... ) ; # 0..* Underlying externally-defined charge item definition
  fhir:partOf  ( [ canonical(ChargeItemDefinition) ] ... ) ; # 0..* A larger definition of which this particular definition is a component or step
  fhir:replaces  ( [ canonical(ChargeItemDefinition) ] ... ) ; # 0..* Completed or terminated request(s) whose function is taken by this new request
  fhir:status [ code ] ; # 1..1 draft | active | retired | unknown
  fhir:experimental [ boolean ] ; # 0..1 For testing purposes, not real usage
  fhir:date [ dateTime ] ; # 0..1 Date last changed
  fhir:account  ( [ Reference(Account) ] ... ) ; # 0..* Candidate account(s) for charge items
  fhir:publisher [ string ] ; # 0..1 Name of the publisher/steward (organization or individual)
  fhir:contact  ( [ ContactDetail ] ... ) ; # 0..* Contact details for the publisher
  fhir:description [ markdown ] ; # 0..1 Natural language description of the charge item definition
  fhir:useContext  ( [ UsageContext ] ... ) ; # 0..* The context that the content is intended to support
  fhir:jurisdiction  ( [ CodeableConcept ] ... ) ; # 0..* Intended jurisdiction for charge item definition (if applicable)
  fhir:purpose [ markdown ] ; # 0..1 Why this charge item definition is defined
  fhir:copyright [ markdown ] ; # 0..1 Use and/or publishing restrictions
  fhir:copyrightLabel [ string ] ; # 0..1 Copyright holder and year(s)
  fhir:approvalDate [ date ] ; # 0..1 When the charge item definition was approved by publisher
  fhir:lastReviewDate [ date ] ; # 0..1 When the charge item definition was last reviewed by the publisher
  fhir:code [ CodeableConcept ] ; # 0..1 Billing code or product type this definition applies to
  fhir:instance  ( [ Reference(ActivityDefinition|Device|DeviceDefinition|HealthcareService|Medication|
  PlanDefinition|Substance) ] ... ) ; # 0..* Instances this definition applies to
  fhir:applicability ( [ # 0..* Whether or not the billing code is applicable
    fhir:condition [ Expression ] ; # 0..1 Boolean-valued expression
    fhir:effectivePeriod [ Period ] ; # 0..1 When the charge item definition is expected to be used
    fhir:relatedArtifact [ RelatedArtifact ] ; # 0..1 Reference to / quotation of the external source of the group of properties
  ] ... ) ;
  fhir:propertyGroup ( [ # 0..* Group of properties which are applicable under the same conditions
    fhir:applicability  ( [ See ChargeItemDefinition.applicability ] ... ) ; # 0..* Conditions under which the priceComponent is applicable
    fhir:priceComponent  ( [ MonetaryComponent ] ... ) ; # 0..* Components of total line item price
  ] ... ) ;
]

Changes from both R4 and R4B

ChargeItemDefinition
ChargeItemDefinition.url
  • Min Cardinality changed from 1 to 0
ChargeItemDefinition.versionAlgorithm[x]
  • Added Element
ChargeItemDefinition.name
  • Added Element
ChargeItemDefinition.account
  • Added Element
ChargeItemDefinition.purpose
  • Added Element
ChargeItemDefinition.copyrightLabel
  • Added Element
ChargeItemDefinition.instance
  • Type Reference: Added Target Types DeviceDefinition, ActivityDefinition, PlanDefinition, HealthcareService
ChargeItemDefinition.applicability.condition
  • Added Element
ChargeItemDefinition.applicability.effectivePeriod
  • Added Element
ChargeItemDefinition.applicability.relatedArtifact
  • Added Element
ChargeItemDefinition.propertyGroup.priceComponent
  • Type changed from BackboneElement to MonetaryComponent
ChargeItemDefinition.effectivePeriod
  • Deleted
ChargeItemDefinition.applicability.description
  • Deleted
ChargeItemDefinition.applicability.language
  • Deleted
ChargeItemDefinition.applicability.expression
  • Deleted
ChargeItemDefinition.propertyGroup.priceComponent.type
  • Deleted
ChargeItemDefinition.propertyGroup.priceComponent.code
  • Deleted
ChargeItemDefinition.propertyGroup.priceComponent.factor
  • Deleted
ChargeItemDefinition.propertyGroup.priceComponent.amount
  • Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ChargeItemDefinition TU DomainResource Definition of properties and rules about how the price and the applicability of a ChargeItem can be determined
+ Warning: Name should be usable as an identifier for the module by machine processing applications such as code generation

Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
Interfaces Implemented: MetadataResource
... url ΣC 0..1 uri Canonical identifier for this charge item definition, represented as a URI (globally unique)
+ Warning: URL should not contain | or # - these characters make processing canonical references problematic
... identifier Σ 0..* Identifier Additional identifier for the charge item definition

... version Σ 0..1 string Business version of the charge item definition
... versionAlgorithm[x] Σ 0..1 How to compare versions
Binding: Version Algorithm (Extensible)
.... versionAlgorithmString string
.... versionAlgorithmCoding Coding
... name ΣC 0..1 string Name for this charge item definition (computer friendly)
... title ΣT 0..1 string Name for this charge item definition (human friendly)
... derivedFromUri Σ 0..* uri Underlying externally-defined charge item definition

... partOf Σ 0..* canonical(ChargeItemDefinition) A larger definition of which this particular definition is a component or step

... replaces Σ 0..* canonical(ChargeItemDefinition) Completed or terminated request(s) whose function is taken by this new request

... status ?!Σ 1..1 code draft | active | retired | unknown
Binding: PublicationStatus (Required)
... experimental Σ 0..1 boolean For testing purposes, not real usage
... date Σ 0..1 dateTime Date last changed
... account Σ 0..* Reference(Account) Candidate account(s) for charge items

... publisher ΣT 0..1 string Name of the publisher/steward (organization or individual)
... contact Σ 0..* ContactDetail Contact details for the publisher

... description ΣT 0..1 markdown Natural language description of the charge item definition
... useContext Σ 0..* UsageContext The context that the content is intended to support

... jurisdiction ΣXD 0..* CodeableConcept Intended jurisdiction for charge item definition (if applicable)
Binding: Jurisdiction ValueSet (Extensible)

... purpose T 0..1 markdown Why this charge item definition is defined
... copyright T 0..1 markdown Use and/or publishing restrictions
... copyrightLabel T 0..1 string Copyright holder and year(s)
... approvalDate 0..1 date When the charge item definition was approved by publisher
... lastReviewDate 0..1 date When the charge item definition was last reviewed by the publisher
... code Σ 0..1 CodeableConcept Billing code or product type this definition applies to
Binding: Charge Item Code (Example)
... instance 0..* Reference(Medication | Substance | Device | DeviceDefinition | ActivityDefinition | PlanDefinition | HealthcareService) Instances this definition applies to

... applicability 0..* BackboneElement Whether or not the billing code is applicable

.... condition 0..1 Expression Boolean-valued expression
.... effectivePeriod Σ 0..1 Period When the charge item definition is expected to be used
.... relatedArtifact 0..1 RelatedArtifact Reference to / quotation of the external source of the group of properties
... propertyGroup 0..* BackboneElement Group of properties which are applicable under the same conditions

.... applicability 0..* see applicability Conditions under which the priceComponent is applicable

.... priceComponent 0..* MonetaryComponent Components of total line item price


doco Documentation for this format icon

See the Extensions for this resource

UML Diagram (Legend)

ChargeItemDefinition (DomainResource) +MetadataResourceAn 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 serversurl : uri [0..1]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 instanceidentifier : Identifier [0..*]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 assetsversion : string [0..1]Indicates the mechanism used to compare versions to determine which is more currentversionAlgorithm[x] : DataType [0..1] « string|Coding; null (Strength=Extensible) VersionAlgorithm+ »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 generationname : string [0..1] « This element has or is affected by some invariantsC »A short, descriptive, user-friendly title for the charge item definitiontitle : string [0..1]The URL pointing to an externally-defined charge item definition that is adhered to in whole or in part by this definitionderivedFromUri : uri [0..*]A larger definition of which this particular definition is a component or steppartOf : canonical [0..*] « ChargeItemDefinition »As new versions of a protocol or guideline are defined, allows identification of what versions are replaced by a new instancereplaces : canonical [0..*] « ChargeItemDefinition »The current state of the ChargeItemDefinition (this element modifies the meaning of other elements)status : code [1..1] « null (Strength=Required)PublicationStatus! »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 usageexperimental : boolean [0..1]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 changesdate : dateTime [0..1] A set of candidate accounts to which charge items using this definition may be assignedaccount : Reference [0..*] « Account »The name of the organization or individual responsible for the release and ongoing maintenance of the charge item definitionpublisher : string [0..1]Contact details to assist a user in finding and communicating with the publishercontact : ContactDetail [0..*]A free text natural language description of the charge item definition from a consumer's perspectivedescription : markdown [0..1]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 instancesuseContext : UsageContext [0..*]A legal or geographic region in which the charge item definition is intended to be usedjurisdiction : CodeableConcept [0..*] « null (Strength=Extensible)JurisdictionValueSet+ »Explanation of why this charge item definition is needed and why it has been designed as it haspurpose : markdown [0..1]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 definitioncopyright : markdown [0..1]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')copyrightLabel : string [0..1]The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usageapprovalDate : date [0..1]The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval datelastReviewDate : date [0..1]The defined billing details in this resource pertain to the given billing codecode : CodeableConcept [0..1] « null (Strength=Example)ChargeItemCode?? »The defined billing details in this resource pertain to the given product instance(s)instance : Reference [0..*] « Medication|Substance|Device| DeviceDefinition|ActivityDefinition|PlanDefinition| HealthcareService »ApplicabilityAn 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 appliedcondition : Expression [0..1]The period during which the charge item definition content was or is planned to be in active useeffectivePeriod : Period [0..1]Reference to / quotation of the external source of the group of propertiesrelatedArtifact : RelatedArtifact [0..1]PropertyGroupThe 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 calculatedpriceComponent : MonetaryComponent [0..*]Expressions that describe applicability criteria for the billing codeapplicability[0..*]Expressions that describe applicability criteria for the priceComponentapplicability[0..*]Group of properties which are applicable under the same conditions. If no applicability rules are established for the group, then all properties always applypropertyGroup[0..*]

XML Template

<ChargeItemDefinition xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Canonical identifier for this charge item definition, represented as a URI (globally unique) -->
 <identifier><!-- 0..* Identifier Additional identifier for the charge item definition --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of the charge item definition -->
 <versionAlgorithm[x]><!-- 0..1 string|Coding How to compare versions --></versionAlgorithm[x]>
 <name value="[string]"/><!-- I 0..1 Name for this charge item definition (computer friendly) -->
 <title value="[string]"/><!-- 0..1 Name for this charge item definition (human friendly) -->
 <derivedFromUri value="[uri]"/><!-- 0..* Underlying externally-defined charge item definition -->
 <partOf><!-- 0..* canonical(ChargeItemDefinition) A larger definition of which this particular definition is a component or step --></partOf>
 <replaces><!-- 0..* canonical(ChargeItemDefinition) Completed or terminated request(s) whose function is taken by this new request --></replaces>
 <status value="[code]"/><!-- 1..1 draft | active | retired | unknown -->
 <experimental value="[boolean]"/><!-- 0..1 For testing purposes, not real usage -->
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <account><!-- 0..* Reference(Account) Candidate account(s) for charge items --></account>
 <publisher value="[string]"/><!-- 0..1 Name of the publisher/steward (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <description value="[markdown]"/><!-- 0..1 Natural language description of the charge item definition -->
 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <jurisdiction><!-- 0..* CodeableConcept Intended jurisdiction for charge item definition (if applicable) --></jurisdiction>
 <purpose value="[markdown]"/><!-- 0..1 Why this charge item definition is defined -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <copyrightLabel value="[string]"/><!-- 0..1 Copyright holder and year(s) -->
 <approvalDate value="[date]"/><!-- 0..1 When the charge item definition was approved by publisher -->
 <lastReviewDate value="[date]"/><!-- 0..1 When the charge item definition was last reviewed by the publisher -->
 <code><!-- 0..1 CodeableConcept Billing code or product type this definition applies to --></code>
 <instance><!-- 0..* Reference(ActivityDefinition|Device|DeviceDefinition|
   HealthcareService|Medication|PlanDefinition|Substance) Instances this definition applies to --></instance>
 <applicability>  <!-- 0..* Whether or not the billing code is applicable -->
  <condition><!-- 0..1 Expression Boolean-valued expression --></condition>
  <effectivePeriod><!-- 0..1 Period When the charge item definition is expected to be used --></effectivePeriod>
  <relatedArtifact><!-- 0..1 RelatedArtifact Reference to / quotation of the external source of the group of properties --></relatedArtifact>
 </applicability>
 <propertyGroup>  <!-- 0..* Group of properties which are applicable under the same conditions -->
  <applicability><!-- 0..* Content as for ChargeItemDefinition.applicability Conditions under which the priceComponent is applicable --></applicability>
  <priceComponent><!-- 0..* MonetaryComponent Components of total line item price --></priceComponent>
 </propertyGroup>
</ChargeItemDefinition>

JSON Template

{doco
  "resourceType" : "ChargeItemDefinition",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Canonical identifier for this charge item definition, represented as a URI (globally unique)
  "identifier" : [{ Identifier }], // Additional identifier for the charge item definition
  "version" : "<string>", // Business version of the charge item definition
  // versionAlgorithm[x]: How to compare versions. One of these 2:
  "versionAlgorithmString" : "<string>",
  "versionAlgorithmCoding" : { Coding },
  "name" : "<string>", // I Name for this charge item definition (computer friendly)
  "title" : "<string>", // Name for this charge item definition (human friendly)
  "derivedFromUri" : ["<uri>"], // Underlying externally-defined charge item definition
  "partOf" : ["<canonical(ChargeItemDefinition)>"], // A larger definition of which this particular definition is a component or step
  "replaces" : ["<canonical(ChargeItemDefinition)>"], // Completed or terminated request(s) whose function is taken by this new request
  "status" : "<code>", // R!  draft | active | retired | unknown
  "experimental" : <boolean>, // For testing purposes, not real usage
  "date" : "<dateTime>", // Date last changed
  "account" : [{ Reference(Account) }], // Candidate account(s) for charge items
  "publisher" : "<string>", // Name of the publisher/steward (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "description" : "<markdown>", // Natural language description of the charge item definition
  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "jurisdiction" : [{ CodeableConcept }], // Intended jurisdiction for charge item definition (if applicable)
  "purpose" : "<markdown>", // Why this charge item definition is defined
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "copyrightLabel" : "<string>", // Copyright holder and year(s)
  "approvalDate" : "<date>", // When the charge item definition was approved by publisher
  "lastReviewDate" : "<date>", // When the charge item definition was last reviewed by the publisher
  "code" : { CodeableConcept }, // Billing code or product type this definition applies to
  "instance" : [{ Reference(ActivityDefinition|Device|DeviceDefinition|
   HealthcareService|Medication|PlanDefinition|Substance) }], // Instances this definition applies to
  "applicability" : [{ // Whether or not the billing code is applicable
    "condition" : { Expression }, // Boolean-valued expression
    "effectivePeriod" : { Period }, // When the charge item definition is expected to be used
    "relatedArtifact" : { RelatedArtifact } // Reference to / quotation of the external source of the group of properties
  }],
  "propertyGroup" : [{ // Group of properties which are applicable under the same conditions
    "applicability" : [{ Content as for ChargeItemDefinition.applicability }], // Conditions under which the priceComponent is applicable
    "priceComponent" : [{ MonetaryComponent }] // Components of total line item price
  }]
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:ChargeItemDefinition;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:url [ uri ] ; # 0..1 Canonical identifier for this charge item definition, represented as a URI (globally unique)
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Additional identifier for the charge item definition
  fhir:version [ string ] ; # 0..1 Business version of the charge item definition
  # versionAlgorithm[x] : 0..1 How to compare versions. One of these 2
    fhir:versionAlgorithm [  a fhir:string ; string ]
    fhir:versionAlgorithm [  a fhir:Coding ; Coding ]
  fhir:name [ string ] ; # 0..1 I Name for this charge item definition (computer friendly)
  fhir:title [ string ] ; # 0..1 Name for this charge item definition (human friendly)
  fhir:derivedFromUri  ( [ uri ] ... ) ; # 0..* Underlying externally-defined charge item definition
  fhir:partOf  ( [ canonical(ChargeItemDefinition) ] ... ) ; # 0..* A larger definition of which this particular definition is a component or step
  fhir:replaces  ( [ canonical(ChargeItemDefinition) ] ... ) ; # 0..* Completed or terminated request(s) whose function is taken by this new request
  fhir:status [ code ] ; # 1..1 draft | active | retired | unknown
  fhir:experimental [ boolean ] ; # 0..1 For testing purposes, not real usage
  fhir:date [ dateTime ] ; # 0..1 Date last changed
  fhir:account  ( [ Reference(Account) ] ... ) ; # 0..* Candidate account(s) for charge items
  fhir:publisher [ string ] ; # 0..1 Name of the publisher/steward (organization or individual)
  fhir:contact  ( [ ContactDetail ] ... ) ; # 0..* Contact details for the publisher
  fhir:description [ markdown ] ; # 0..1 Natural language description of the charge item definition
  fhir:useContext  ( [ UsageContext ] ... ) ; # 0..* The context that the content is intended to support
  fhir:jurisdiction  ( [ CodeableConcept ] ... ) ; # 0..* Intended jurisdiction for charge item definition (if applicable)
  fhir:purpose [ markdown ] ; # 0..1 Why this charge item definition is defined
  fhir:copyright [ markdown ] ; # 0..1 Use and/or publishing restrictions
  fhir:copyrightLabel [ string ] ; # 0..1 Copyright holder and year(s)
  fhir:approvalDate [ date ] ; # 0..1 When the charge item definition was approved by publisher
  fhir:lastReviewDate [ date ] ; # 0..1 When the charge item definition was last reviewed by the publisher
  fhir:code [ CodeableConcept ] ; # 0..1 Billing code or product type this definition applies to
  fhir:instance  ( [ Reference(ActivityDefinition|Device|DeviceDefinition|HealthcareService|Medication|
  PlanDefinition|Substance) ] ... ) ; # 0..* Instances this definition applies to
  fhir:applicability ( [ # 0..* Whether or not the billing code is applicable
    fhir:condition [ Expression ] ; # 0..1 Boolean-valued expression
    fhir:effectivePeriod [ Period ] ; # 0..1 When the charge item definition is expected to be used
    fhir:relatedArtifact [ RelatedArtifact ] ; # 0..1 Reference to / quotation of the external source of the group of properties
  ] ... ) ;
  fhir:propertyGroup ( [ # 0..* Group of properties which are applicable under the same conditions
    fhir:applicability  ( [ See ChargeItemDefinition.applicability ] ... ) ; # 0..* Conditions under which the priceComponent is applicable
    fhir:priceComponent  ( [ MonetaryComponent ] ... ) ; # 0..* Components of total line item price
  ] ... ) ;
]

Changes from both R4 and R4B

ChargeItemDefinition
ChargeItemDefinition.url
  • Min Cardinality changed from 1 to 0
ChargeItemDefinition.versionAlgorithm[x]
  • Added Element
ChargeItemDefinition.name
  • Added Element
ChargeItemDefinition.account
  • Added Element
ChargeItemDefinition.purpose
  • Added Element
ChargeItemDefinition.copyrightLabel
  • Added Element
ChargeItemDefinition.instance
  • Type Reference: Added Target Types DeviceDefinition, ActivityDefinition, PlanDefinition, HealthcareService
ChargeItemDefinition.applicability.condition
  • Added Element
ChargeItemDefinition.applicability.effectivePeriod
  • Added Element
ChargeItemDefinition.applicability.relatedArtifact
  • Added Element
ChargeItemDefinition.propertyGroup.priceComponent
  • Type changed from BackboneElement to MonetaryComponent
ChargeItemDefinition.effectivePeriod
  • Deleted
ChargeItemDefinition.applicability.description
  • Deleted
ChargeItemDefinition.applicability.language
  • Deleted
ChargeItemDefinition.applicability.expression
  • Deleted
ChargeItemDefinition.propertyGroup.priceComponent.type
  • Deleted
ChargeItemDefinition.propertyGroup.priceComponent.code
  • Deleted
ChargeItemDefinition.propertyGroup.priceComponent.factor
  • Deleted
ChargeItemDefinition.propertyGroup.priceComponent.amount
  • Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

 

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) , the spreadsheet version & the dependency analysis

8.29.4.1 Terminology Bindings

Path ValueSet Type Documentation
ChargeItemDefinition.versionAlgorithm[x] VersionAlgorithm Extensible

Indicates the mechanism used to compare versions to determine which is more current.
ChargeItemDefinition.status PublicationStatus Required

The lifecycle status of an artifact.
ChargeItemDefinition.jurisdiction JurisdictionValueSet Extensible

This value set defines a base set of codes for country, country subdivision and region for indicating where a resource is intended to be used.

Note: The codes for countries and country subdivisions are taken from ISO 3166 icon while the codes for "supra-national" regions are from UN Standard country or area codes for statistical use (M49) icon.
ChargeItemDefinition.code ChargeItemCode Example

Example set of codes that can be used for billing purposes.

8.29.4.2 Constraints

UniqueKeyLevelLocationDescriptionExpression
img cnl-0Warning (base)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}$')
img cnl-1Warning ChargeItemDefinition.urlURL should not contain | or # - these characters make processing canonical references problematicexists() implies matches('^[^|# ]+$')



8.29.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
account reference Candidate account for charge items ChargeItemDefinition.account
(Account)
context token A use context assigned to the charge item definition (ChargeItemDefinition.useContext.value.ofType(CodeableConcept)) 30 Resources
context-quantity quantity A quantity- or range-valued use context assigned to the charge item definition (ChargeItemDefinition.useContext.value.ofType(Quantity)) | (ChargeItemDefinition.useContext.value.ofType(Range)) 30 Resources
context-type token A type of use context assigned to the charge item definition ChargeItemDefinition.useContext.code 30 Resources
context-type-quantity composite A use context type and quantity- or range-based value assigned to the charge item definition On ChargeItemDefinition.useContext:
  context-type: code
  context-quantity: value.ofType(Quantity) | value.ofType(Range)		 30 Resources
context-type-value composite A use context type and value assigned to the charge item definition On ChargeItemDefinition.useContext:
  context-type: code
  context: value.ofType(CodeableConcept)		 30 Resources
date date The charge item definition publication date ChargeItemDefinition.date 30 Resources
description string The description of the charge item definition ChargeItemDefinition.description 28 Resources
effective date The time during which the charge item definition is intended to be in use ChargeItemDefinition.applicability.effectivePeriod 12 Resources
identifier token External identifier for the charge item definition ChargeItemDefinition.identifier 36 Resources
jurisdiction token Intended jurisdiction for the charge item definition ChargeItemDefinition.jurisdiction 26 Resources
publisher string Name of the publisher of the charge item definition ChargeItemDefinition.publisher 30 Resources
status token The current status of the charge item definition ChargeItemDefinition.status 36 Resources
title string The human-friendly name of the charge item definition ChargeItemDefinition.title 27 Resources
url uri The uri that identifies the charge item definition ChargeItemDefinition.url 35 Resources
version token The business version of the charge item definition ChargeItemDefinition.version 31 Resources