Consumer-Directed Payer Data Exchange
- Release 0.1.0

Consumer-Directed Payer Data Exchange, published by CARIN Alliance. This is not an authorized publication; it is the continuous build for version 0.1.0). This version is based on the current content of https://github.com/HL7/carin-bb/ and changes regularly. See the Directory of published versions

SD.4 StructureDefinition-CARIN-BB-ExplanationOfBenefit-Inpatient-Facility

This profile is built upon the CARINBBExplanationOfBenefit Profile. The profile is used for Explanation of Benefits (EOBs) based on claims submitted by clinics, hospitals, skilled nursing facilities and other institutions for inpatient services, which may include the use of equipment and supplies, laboratory services, radiology services and other charges. Inpatient claims are submitted for services rendered at a facility as part of an overnight stay. The claims data is based on the institutional claim format UB-04, submission standards adopted by the Department of Health and Human Services as form CMS-1450.

SD.4.1 Formal Views of Profile Content

Description of Profiles, Differentials, and Snapshots.

The official URL for this profile is: http://hl7.org/fhir/us/carin/StructureDefinition/carin-bb-explanationofbenefit-inpatient-facility

Published on Fri Jul 26 00:00:00 UTC 2019 as a active by CARIN Alliance.

This profile builds on CARINBBExplanationOfBenefit


Summary

Mandatory: 3 elements (13 nested mandatory elements)
Fixed Value: 14 elements

Slices

This structure defines the following Slices:

  • The element ExplanationOfBenefit.supportingInfo is sliced based on the value of value:category
  • The element ExplanationOfBenefit.item.adjudication is sliced based on the value of value:category (Closed)
NameFlagsCard.TypeDescription & Constraintsdoco
.. ExplanationOfBenefit 0..*CARINBBExplanationOfBenefit
... type 1..1CodeableConceptRequired Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: inpatient-facility
... supportingInfo 0..*(Slice Definition)Slice: Unordered, Open by value:category
.... supportingInfo:billingnetworkcontractingstatus 0..1BackboneElement
..... category 1..1CodeableConceptFixed Value: As shown (billingnetworkcontractingstatus)
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: billingnetworkcontractingstatus
..... code 1..1CodeableConceptBinding: CARIN Blue Button Network Contracting Status Value Set (required)
.... supportingInfo:attendingnetworkcontractingstatus 0..1BackboneElement
..... category 1..1CodeableConceptFixed Value: As shown (attendingnetworkcontractingstatus)
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: attendingnetworkcontractingstatus
..... code 1..1CodeableConceptBinding: CARIN Blue Button Network Contracting Status Value Set (required)
.... supportingInfo:referringnetworkcontractingstatus 0..1BackboneElement
..... category 1..1CodeableConceptFixed Value: As shown (referringnetworkcontractingstatus)
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: referringnetworkcontractingstatus
..... code 1..1CodeableConceptBinding: CARIN Blue Button Network Contracting Status Value Set (required)
.... supportingInfo:clmrecvddate 1..1BackboneElement
..... category 1..1CodeableConceptFixed Value: As shown (clmrecvddate)
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: clmrecvddate
..... timing[x] 1..1date
.... supportingInfo:typeofservice 0..1BackboneElement
..... category 1..1CodeableConceptFixed Value: As shown (typeofservice for inpatient)
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: typeofservice
..... code 1..1CodeableConceptBinding: CARIN Blue Button Type Of Service Value Set (required)
.... supportingInfo:tob-typeoffacility 0..1BackboneElement
..... category 1..1CodeableConceptFixed Value: As shown (tob-typeoffacility)
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: tob-typeoffacility
..... code 1..1CodeableConceptBinding: CARIN Blue Button Type Of Bill (Type Of Facility) Value Set (required)
.... supportingInfo:tob-billclassification 0..1BackboneElement
..... category 1..1CodeableConceptFixed Value: As shown (tob-billclassification)
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: tob-billclassification
..... code 1..1CodeableConceptBinding: CARIN Blue Button Type Of Bill (Bill Classification) Value Set (required)
.... supportingInfo:tob-frequency 0..1BackboneElement
..... category 1..1CodeableConceptFixed Value: As shown (tob-frequency)
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: tob-frequency
..... code 1..1CodeableConceptBinding: CARIN Blue Button Type Of Bill (Frequency) Value Set (required)
.... supportingInfo:admsrc 0..1BackboneElement
..... category 1..1CodeableConceptFixed Value: As shown (admsrc)
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: admsrc
..... code 1..1CodeableConceptBinding: NUBC Point of Origin for Admission or Visit Value Set (required)
.... supportingInfo:admtype 0..1BackboneElement
..... category 1..1CodeableConceptFixed Value: As shown (admtype)
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: admtype
..... code 1..1CodeableConceptBinding: NUBC Priority (Type) of Admission or Visit Value Set (required)
.... supportingInfo:discharge-status 0..1BackboneElement
..... category 1..1CodeableConceptFixed Value: As shown (discharge-status)
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: discharge-status
..... code 1..1CodeableConceptBinding: NUBC Patient Discharge Status (required)
.... supportingInfo:ms-drg 0..1BackboneElement
..... category 1..1CodeableConceptFixed Value: As shown (ms-drg)
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: ms-drg
..... code 1..1CodeableConceptBinding: CARIN Blue Button MS-DRG Value Set (required)
.... supportingInfo:placeofservice 0..1BackboneElement
..... category 1..1CodeableConceptFixed Value: As shown (placeofservice)
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: placeofservice
... item
.... revenue 1..1CodeableConceptBinding: CARIN Blue Button Revenue Center Value Set (required)
.... productOrService 1..1CodeableConceptBinding: CARIN Blue Button SNOMEDCT Procedure Codes Value Set (required)
.... adjudication 0..*(Slice Definition)Slice: Unordered, Closed by value:category
..... adjudication:All Slices Content/Rules for all slices
...... category 1..1CodeableConceptBinding: CARIN Blue Button Claim Adjudication Category Value Set (required)
..... adjudication:adjudicationamounttype 0..*BackboneElement
...... category 1..1CodeableConceptBinding: CARIN Blue Button Adjudication Amount Category Value Set (required)
..... adjudication:denialreason 0..1BackboneElement
...... category 1..1CodeableConceptFixed Value: As shown (payment denial reason)
....... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
........ system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-adjudicationcategory
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: denialreason
...... reason 1..1CodeableConceptBinding: CARIN Blue Button Adjudication Denial Reason Value Set (required)
... total 1..*BackboneElement

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. ExplanationOfBenefit I0..*CARINBBExplanationOfBenefitExplanation of Benefit resource
... id Σ1..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier SI1..*IdentifierBusiness Identifier for the resource
... status ?!ΣI1..1codeactive | cancelled | draft | entered-in-error
Binding: ExplanationOfBenefitStatus (required)
... type ΣI1..1CodeableConceptCategory or discipline
Binding: CARIN Blue Button Claim Type Value Set (extensible)
Required Pattern: At least the following
.... id0..1stringUnique id for inter-element referencing
.... extension0..*ExtensionAdditional content defined by implementations
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system0..1uriIdentity of the terminology system
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: inpatient-facility
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
... subType I0..1CodeableConceptMore granular claim type
Binding: ExampleClaimSubTypeCodes (example)
... use ΣI1..1codeclaim | preauthorization | predetermination
Binding: Use (required)
Required Pattern: claim
... patient ΣI1..1Reference(CARIN Blue Button Patient Profile)The recipient of the products and services
... billablePeriod SΣI0..1PeriodRelevant time frame for the claim
... created ΣI1..1dateTimeResponse creation date
... enterer I0..1Reference(Practitioner | PractitionerRole)Author of the claim
... insurer ΣI1..1Reference(CARIN Blue Button Organization Profile)Party responsible for reimbursement
... provider ΣI1..1Reference(CARIN Blue Button Organization Profile)Party responsible for the claim
... priority I0..1CodeableConceptDesired processing urgency
Binding: http://terminology.hl7.org/CodeSystem/processpriority (example)
... fundsReserveRequested I0..1CodeableConceptFor whom to reserve funds
Binding: Funds Reservation Codes (example)
... fundsReserve I0..1CodeableConceptFunds reserved status
Binding: Funds Reservation Codes (example)
... related SI0..*BackboneElementPrior or corollary claims
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... claim I0..1Reference(Claim)Reference to the related claim
.... relationship I1..1CodeableConceptHow the reference claim is related
Binding: CARIN Blue Button Related Claim Relationship Value Set (extensible)
.... reference I0..1IdentifierFile or case reference
... prescription I0..1Reference(MedicationRequest | VisionPrescription)Prescription authorizing services or products
... originalPrescription I0..1Reference(MedicationRequest)Original prescription if superceded by fulfiller
... payee SI0..1BackboneElementRecipient of benefits payable
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type I1..1CodeableConceptCategory of recipient
Binding: Claim Payee Type Codes (example)
.... party I1..1Reference(CARIN Blue Button Practitioner Role Profile | CARIN Blue Button Patient Profile)Recipient reference
... referral I0..1Reference(ServiceRequest)Treatment Referral
... facility I0..1Reference(Location)Servicing Facility
... claim I0..1Reference(Claim)Claim reference
... claimResponse I0..1Reference(ClaimResponse)Claim response reference
... outcome ΣI1..1codequeued | complete | error | partial
Binding: ClaimProcessingCodes (required)
... disposition I0..1stringDisposition Message
... preAuthRef I0..*stringPreauthorization reference
... preAuthRefPeriod I0..*PeriodPreauthorization in-effect period
... careTeam SI0..*BackboneElementCare Team members
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence I1..1positiveIntOrder of care team
.... provider I1..1Reference(CARIN Blue Button Practitioner Role Profile)Practitioner or organization
.... responsible SI0..1booleanIndicator of the lead practitioner
.... role I1..1CodeableConceptFunction within the team
Binding: CARIN Blue Button Claim Care Team Role Value Set (extensible)
.... qualification I0..1CodeableConceptPractitioner credential or specialization
Binding: ExampleProviderQualificationCodes (example)
... supportingInfo SI0..*(Slice Definition)Supporting information
Slice: Unordered, Open by value:category
.... supportingInfo:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence I1..1positiveIntInformation instance identifier
..... category I1..1CodeableConceptClassification of the supplied information
Binding: CARIN Blue Button Claim Information Category Value Set (extensible)
..... code SI0..1CodeableConceptType of information
Binding: ExceptionCodes (example)
..... timing[x] SI0..1When it occurred
...... timingDatedate
...... timingPeriodPeriod
..... value[x] SI0..1Data to be provided
...... valueBooleanboolean
...... valueStringstring
...... valueQuantityQuantity
...... valueAttachmentAttachment
...... valueReferenceReference(Resource)
..... reason I0..1CodingExplanation for the information
Binding: MissingToothReasonCodes (example)
.... supportingInfo:billingnetworkcontractingstatus SI0..1BackboneElementSupporting information
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence I1..1positiveIntInformation instance identifier
..... category I1..1CodeableConceptClassification of the supplied information
Binding: CARIN Blue Button Claim Information Category Value Set (extensible)
Fixed Value: As shown (billingnetworkcontractingstatus)
...... id0..0stringUnique id for inter-element referencing
...... extension0..0ExtensionAdditional content defined by implementations
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..0stringUnique id for inter-element referencing
....... extension0..0ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... version0..0stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: billingnetworkcontractingstatus
....... display0..0stringRepresentation defined by the system
....... userSelected0..0booleanIf this coding was chosen directly by the user
...... text0..0stringPlain text representation of the concept
..... code SI1..1CodeableConceptType of information
Binding: CARIN Blue Button Network Contracting Status Value Set (required)
..... timing[x] SI0..1When it occurred
...... timingDatedate
...... timingPeriodPeriod
..... value[x] SI0..1Data to be provided
...... valueBooleanboolean
...... valueStringstring
...... valueQuantityQuantity
...... valueAttachmentAttachment
...... valueReferenceReference(Resource)
..... reason I0..1CodingExplanation for the information
Binding: MissingToothReasonCodes (example)
.... supportingInfo:attendingnetworkcontractingstatus SI0..1BackboneElementSupporting information
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence I1..1positiveIntInformation instance identifier
..... category I1..1CodeableConceptClassification of the supplied information
Binding: CARIN Blue Button Claim Information Category Value Set (extensible)
Fixed Value: As shown (attendingnetworkcontractingstatus)
...... id0..0stringUnique id for inter-element referencing
...... extension0..0ExtensionAdditional content defined by implementations
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..0stringUnique id for inter-element referencing
....... extension0..0ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... version0..0stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: attendingnetworkcontractingstatus
....... display0..0stringRepresentation defined by the system
....... userSelected0..0booleanIf this coding was chosen directly by the user
...... text0..0stringPlain text representation of the concept
..... code SI1..1CodeableConceptType of information
Binding: CARIN Blue Button Network Contracting Status Value Set (required)
..... timing[x] SI0..1When it occurred
...... timingDatedate
...... timingPeriodPeriod
..... value[x] SI0..1Data to be provided
...... valueBooleanboolean
...... valueStringstring
...... valueQuantityQuantity
...... valueAttachmentAttachment
...... valueReferenceReference(Resource)
..... reason I0..1CodingExplanation for the information
Binding: MissingToothReasonCodes (example)
.... supportingInfo:referringnetworkcontractingstatus SI0..1BackboneElementSupporting information
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence I1..1positiveIntInformation instance identifier
..... category I1..1CodeableConceptClassification of the supplied information
Binding: CARIN Blue Button Claim Information Category Value Set (extensible)
Fixed Value: As shown (referringnetworkcontractingstatus)
...... id0..0stringUnique id for inter-element referencing
...... extension0..0ExtensionAdditional content defined by implementations
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..0stringUnique id for inter-element referencing
....... extension0..0ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... version0..0stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: referringnetworkcontractingstatus
....... display0..0stringRepresentation defined by the system
....... userSelected0..0booleanIf this coding was chosen directly by the user
...... text0..0stringPlain text representation of the concept
..... code SI1..1CodeableConceptType of information
Binding: CARIN Blue Button Network Contracting Status Value Set (required)
..... timing[x] SI0..1When it occurred
...... timingDatedate
...... timingPeriodPeriod
..... value[x] SI0..1Data to be provided
...... valueBooleanboolean
...... valueStringstring
...... valueQuantityQuantity
...... valueAttachmentAttachment
...... valueReferenceReference(Resource)
..... reason I0..1CodingExplanation for the information
Binding: MissingToothReasonCodes (example)
.... supportingInfo:clmrecvddate SI1..1BackboneElementSupporting information
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence I1..1positiveIntInformation instance identifier
..... category I1..1CodeableConceptClassification of the supplied information
Binding: CARIN Blue Button Claim Information Category Value Set (extensible)
Fixed Value: As shown (clmrecvddate)
...... id0..0stringUnique id for inter-element referencing
...... extension0..0ExtensionAdditional content defined by implementations
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..0stringUnique id for inter-element referencing
....... extension0..0ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... version0..0stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: clmrecvddate
....... display0..0stringRepresentation defined by the system
....... userSelected0..0booleanIf this coding was chosen directly by the user
...... text0..0stringPlain text representation of the concept
..... code SI0..1CodeableConceptType of information
Binding: ExceptionCodes (example)
..... timing[x] SI1..1dateWhen it occurred
..... value[x] SI0..1Data to be provided
...... valueBooleanboolean
...... valueStringstring
...... valueQuantityQuantity
...... valueAttachmentAttachment
...... valueReferenceReference(Resource)
..... reason I0..1CodingExplanation for the information
Binding: MissingToothReasonCodes (example)
.... supportingInfo:typeofservice SI0..1BackboneElementSupporting information
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence I1..1positiveIntInformation instance identifier
..... category I1..1CodeableConceptClassification of the supplied information
Binding: CARIN Blue Button Claim Information Category Value Set (extensible)
Fixed Value: As shown (typeofservice for inpatient)
...... id0..0stringUnique id for inter-element referencing
...... extension0..0ExtensionAdditional content defined by implementations
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..0stringUnique id for inter-element referencing
....... extension0..0ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... version0..0stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: typeofservice
....... display0..0stringRepresentation defined by the system
....... userSelected0..0booleanIf this coding was chosen directly by the user
...... text0..0stringPlain text representation of the concept
..... code SI1..1CodeableConceptType of information
Binding: CARIN Blue Button Type Of Service Value Set (required)
..... timing[x] SI0..1When it occurred
...... timingDatedate
...... timingPeriodPeriod
..... value[x] SI0..1Data to be provided
...... valueBooleanboolean
...... valueStringstring
...... valueQuantityQuantity
...... valueAttachmentAttachment
...... valueReferenceReference(Resource)
..... reason I0..1CodingExplanation for the information
Binding: MissingToothReasonCodes (example)
.... supportingInfo:tob-typeoffacility SI0..1BackboneElementSupporting information
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence I1..1positiveIntInformation instance identifier
..... category I1..1CodeableConceptClassification of the supplied information
Binding: CARIN Blue Button Claim Information Category Value Set (extensible)
Fixed Value: As shown (tob-typeoffacility)
...... id0..0stringUnique id for inter-element referencing
...... extension0..0ExtensionAdditional content defined by implementations
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..0stringUnique id for inter-element referencing
....... extension0..0ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... version0..0stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: tob-typeoffacility
....... display0..0stringRepresentation defined by the system
....... userSelected0..0booleanIf this coding was chosen directly by the user
...... text0..0stringPlain text representation of the concept
..... code SI1..1CodeableConceptType of information
Binding: CARIN Blue Button Type Of Bill (Type Of Facility) Value Set (required)
..... timing[x] SI0..1When it occurred
...... timingDatedate
...... timingPeriodPeriod
..... value[x] SI0..1Data to be provided
...... valueBooleanboolean
...... valueStringstring
...... valueQuantityQuantity
...... valueAttachmentAttachment
...... valueReferenceReference(Resource)
..... reason I0..1CodingExplanation for the information
Binding: MissingToothReasonCodes (example)
.... supportingInfo:tob-billclassification SI0..1BackboneElementSupporting information
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence I1..1positiveIntInformation instance identifier
..... category I1..1CodeableConceptClassification of the supplied information
Binding: CARIN Blue Button Claim Information Category Value Set (extensible)
Fixed Value: As shown (tob-billclassification)
...... id0..0stringUnique id for inter-element referencing
...... extension0..0ExtensionAdditional content defined by implementations
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..0stringUnique id for inter-element referencing
....... extension0..0ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... version0..0stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: tob-billclassification
....... display0..0stringRepresentation defined by the system
....... userSelected0..0booleanIf this coding was chosen directly by the user
...... text0..0stringPlain text representation of the concept
..... code SI1..1CodeableConceptType of information
Binding: CARIN Blue Button Type Of Bill (Bill Classification) Value Set (required)
..... timing[x] SI0..1When it occurred
...... timingDatedate
...... timingPeriodPeriod
..... value[x] SI0..1Data to be provided
...... valueBooleanboolean
...... valueStringstring
...... valueQuantityQuantity
...... valueAttachmentAttachment
...... valueReferenceReference(Resource)
..... reason I0..1CodingExplanation for the information
Binding: MissingToothReasonCodes (example)
.... supportingInfo:tob-frequency SI0..1BackboneElementSupporting information
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence I1..1positiveIntInformation instance identifier
..... category I1..1CodeableConceptClassification of the supplied information
Binding: CARIN Blue Button Claim Information Category Value Set (extensible)
Fixed Value: As shown (tob-frequency)
...... id0..0stringUnique id for inter-element referencing
...... extension0..0ExtensionAdditional content defined by implementations
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..0stringUnique id for inter-element referencing
....... extension0..0ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... version0..0stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: tob-frequency
....... display0..0stringRepresentation defined by the system
....... userSelected0..0booleanIf this coding was chosen directly by the user
...... text0..0stringPlain text representation of the concept
..... code SI1..1CodeableConceptType of information
Binding: CARIN Blue Button Type Of Bill (Frequency) Value Set (required)
..... timing[x] SI0..1When it occurred
...... timingDatedate
...... timingPeriodPeriod
..... value[x] SI0..1Data to be provided
...... valueBooleanboolean
...... valueStringstring
...... valueQuantityQuantity
...... valueAttachmentAttachment
...... valueReferenceReference(Resource)
..... reason I0..1CodingExplanation for the information
Binding: MissingToothReasonCodes (example)
.... supportingInfo:admsrc SI0..1BackboneElementSupporting information
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence I1..1positiveIntInformation instance identifier
..... category I1..1CodeableConceptClassification of the supplied information
Binding: CARIN Blue Button Claim Information Category Value Set (extensible)
Fixed Value: As shown (admsrc)
...... id0..0stringUnique id for inter-element referencing
...... extension0..0ExtensionAdditional content defined by implementations
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..0stringUnique id for inter-element referencing
....... extension0..0ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... version0..0stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: admsrc
....... display0..0stringRepresentation defined by the system
....... userSelected0..0booleanIf this coding was chosen directly by the user
...... text0..0stringPlain text representation of the concept
..... code SI1..1CodeableConceptType of information
Binding: NUBC Point of Origin for Admission or Visit Value Set (required)
..... timing[x] SI0..1When it occurred
...... timingDatedate
...... timingPeriodPeriod
..... value[x] SI0..1Data to be provided
...... valueBooleanboolean
...... valueStringstring
...... valueQuantityQuantity
...... valueAttachmentAttachment
...... valueReferenceReference(Resource)
..... reason I0..1CodingExplanation for the information
Binding: MissingToothReasonCodes (example)
.... supportingInfo:admtype SI0..1BackboneElementSupporting information
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence I1..1positiveIntInformation instance identifier
..... category I1..1CodeableConceptClassification of the supplied information
Binding: CARIN Blue Button Claim Information Category Value Set (extensible)
Fixed Value: As shown (admtype)
...... id0..0stringUnique id for inter-element referencing
...... extension0..0ExtensionAdditional content defined by implementations
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..0stringUnique id for inter-element referencing
....... extension0..0ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... version0..0stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: admtype
....... display0..0stringRepresentation defined by the system
....... userSelected0..0booleanIf this coding was chosen directly by the user
...... text0..0stringPlain text representation of the concept
..... code SI1..1CodeableConceptType of information
Binding: NUBC Priority (Type) of Admission or Visit Value Set (required)
..... timing[x] SI0..1When it occurred
...... timingDatedate
...... timingPeriodPeriod
..... value[x] SI0..1Data to be provided
...... valueBooleanboolean
...... valueStringstring
...... valueQuantityQuantity
...... valueAttachmentAttachment
...... valueReferenceReference(Resource)
..... reason I0..1CodingExplanation for the information
Binding: MissingToothReasonCodes (example)
.... supportingInfo:discharge-status SI0..1BackboneElementSupporting information
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence I1..1positiveIntInformation instance identifier
..... category I1..1CodeableConceptClassification of the supplied information
Binding: CARIN Blue Button Claim Information Category Value Set (extensible)
Fixed Value: As shown (discharge-status)
...... id0..0stringUnique id for inter-element referencing
...... extension0..0ExtensionAdditional content defined by implementations
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..0stringUnique id for inter-element referencing
....... extension0..0ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... version0..0stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: discharge-status
....... display0..0stringRepresentation defined by the system
....... userSelected0..0booleanIf this coding was chosen directly by the user
...... text0..0stringPlain text representation of the concept
..... code SI1..1CodeableConceptType of information
Binding: NUBC Patient Discharge Status (required)
..... timing[x] SI0..1When it occurred
...... timingDatedate
...... timingPeriodPeriod
..... value[x] SI0..1Data to be provided
...... valueBooleanboolean
...... valueStringstring
...... valueQuantityQuantity
...... valueAttachmentAttachment
...... valueReferenceReference(Resource)
..... reason I0..1CodingExplanation for the information
Binding: MissingToothReasonCodes (example)
.... supportingInfo:ms-drg SI0..1BackboneElementSupporting information
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence I1..1positiveIntInformation instance identifier
..... category I1..1CodeableConceptClassification of the supplied information
Binding: CARIN Blue Button Claim Information Category Value Set (extensible)
Fixed Value: As shown (ms-drg)
...... id0..0stringUnique id for inter-element referencing
...... extension0..0ExtensionAdditional content defined by implementations
...... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
....... id0..0stringUnique id for inter-element referencing
....... extension0..0ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory
....... version0..0stringVersion of the system - if relevant
....... code1..1codeSymbol in syntax defined by the system
Fixed Value: ms-drg
....... display0..0stringRepresentation defined by the system
....... userSelected0..0booleanIf this coding was chosen directly by the user
...... text0..0stringPlain text representation of the concept
..... code SI1..1CodeableConceptType of information
Binding: CARIN Blue Button MS-DRG Value Set (required)
..... timing[x] SI0..1When it occurred
...... timingDatedate
...... timingPeriodPeriod
..... value[x] SI0..1Data to be provided
...... valueBooleanboolean
...... valueStringstring
...... valueQuantityQuantity
...... valueAttachmentAttachment
...... valueReferenceReference(Resource)
..... reason I0..1CodingExplanation for the information
Binding: MissingToothReasonCodes (example)
.... supportingInfo:placeofservice SI0..1BackboneElementSupporting information
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence I1..1positiveIntInformation instance identifier
..... category I1..1CodeableConceptClassification of the supplied information
Binding: CARIN Blue Button Claim Information Category Value Set (extensible)
Fixed Value: As shown (placeofservice)
...... id0..0stringUnique id for inter-element referencing
...... extension0..0ExtensionAdditional content defined by implementations
...... coding1..1