Profile Comparison between http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim vs http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim

Left:PAS Claim (http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim)
Right:PAS Claim (http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim)

Messages

ErrorStructureDefinition.versionValues for version differ: '2.0.1' vs '2.1.0'
InformationStructureDefinition.dateValues for date differ: '2023-12-01T20:58:53+00:00' vs '2024-12-20T19:33:39+00:00'
InformationStructureDefinition.shortValues for short differ: 'Claim, Pre-determination or Pre-authorization' vs 'Preauthorization'
InformationClaim.identifierElement maximum cardinalities differ: '1' vs '2'
WarningClaim.statusElements differ in definition for mustSupport: 'false' vs 'true'
WarningClaim.useElements differ in definition for mustSupport: 'false' vs 'true'
WarningClaim.patientElements differ in definition for mustSupport: 'false' vs 'true'
InformationClaim.relatedElement maximum cardinalities differ: '2147483647' vs '0'
InformationStructureDefinition.commentValues for comment differ: 'Dates need to be a full date - YYYY-MM-DD' vs 'The date of the accident has to precede the dates of the products and services but within a reasonable timeframe.'
WarningClaim.accident.location[x]Elements differ in definition for mustSupport: 'false' vs 'true'
InformationClaim.item.extensionElement minimum cardinalities differ: '0' vs '2'
InformationClaim.item.location[x]Element minimum cardinalities differ: '0' vs '1'
InformationStructureDefinition.shortValues for short differ: 'Count of products or services' vs 'A fixed quantity (no comparator)'
InformationStructureDefinition.definitionValues for definition differ: 'The number of repetitions of a service or product.' vs 'The comparator is not used on a SimpleQuantity'

Metadata

NameValueComments
.abstractfalse
    .baseDefinitionhttp://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-base
      .copyright
        .date2023-12-01T20:58:53+00:002024-12-20T19:33:39+00:00
        • Values Differ
        .descriptionPAS constraints on Claim resource mandating support for elements relevant to the prior authorization request
          .experimental
            .fhirVersion4.0.1
              .jurisdiction
                ..jurisdiction[0]urn:iso:std:iso:3166#US
                  .kindresource
                    .namePASClaim
                      .publisherHL7 International / Financial Management
                        .purpose
                          .statusactive
                            .titlePAS Claim
                              .typeClaim
                                .urlhttp://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim
                                  .version2.0.12.1.0
                                  • Values Differ

                                  Structure

                                  NameL FlagsL Card.L TypeL Description & ConstraintsR FlagsR Card.R TypeR Description & ConstraintsCommentsdoco
                                  .. Claim 0..*PASClaimBaseClaim, Pre-determination or Pre-authorization
                                  0..*PASClaimBasePreauthorization
                                    ... id Σ0..1idLogical id of this artifactΣ0..1idLogical id of this artifact
                                      ... meta Σ0..1MetaMetadata about the resourceΣ0..1MetaMetadata about the resource
                                        ... implicitRules ?!Σ0..1uriA set of rules under which this content was created?!Σ0..1uriA set of rules under which this content was created
                                          ... language 0..1codeLanguage of the resource content
                                          Binding: ?? (preferred): A human language.

                                          Additional BindingsPurpose
                                          ??Max Binding
                                          0..1codeLanguage of the resource content
                                          Binding: ?? (preferred): A human language.

                                          Additional BindingsPurpose
                                          ??Max Binding
                                            ... text 0..1NarrativeText summary of the resource, for human interpretation0..1NarrativeText summary of the resource, for human interpretation
                                              ... contained 0..*ResourceContained, inline Resources
                                              0..*ResourceContained, inline Resources
                                                ... Slices for extension 0..*ExtensionExtension
                                                Slice: Unordered, Open by value:url
                                                0..*ExtensionExtension
                                                Slice: Unordered, Open by value:url
                                                  ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
                                                  ?!0..*ExtensionExtensions that cannot be ignored
                                                    ... identifier S1..1??Business identifier for claim
                                                    S1..2??Business identifier for claim
                                                    • Element maximum cardinalities differ: '1' vs '2'
                                                    .... id 0..1stringUnique id for inter-element referencing
                                                    • Added this element
                                                    .... Slices for extension 0..*ExtensionAdditional content defined by implementations
                                                    Slice: Unordered, Open by value:url
                                                    • Added this element
                                                    .... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
                                                    Binding: ?? (required): Identifies the purpose for this identifier, if known .

                                                    • Added this element
                                                    .... type Σ0..1CodeableConceptDescription of identifier
                                                    Binding: ?? (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                                                    • Added this element
                                                    .... system SΣ1..1uriSHOULD use a scheme of 'urn:trnorg:<TRN03>'
                                                    Example General: http://www.acme.com/identifiers/patient
                                                    • Added this element
                                                    .... value SΣ1..1stringThe value that is unique
                                                    Example General: 123456
                                                    • Added this element
                                                    .... period Σ0..1PeriodTime period when id is/was valid for use
                                                    • Added this element
                                                    .... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
                                                    • Added this element
                                                    ... status ?!Σ1..1codeactive | cancelled | draft | entered-in-error
                                                    Binding: ?? (required): A code specifying the state of the resource instance.


                                                    Required Pattern: active
                                                    ?!SΣ1..1codeactive | cancelled | draft | entered-in-error
                                                    Binding: ?? (required): A code specifying the state of the resource instance.


                                                    Required Pattern: active
                                                    • Elements differ in definition for mustSupport: 'false' vs 'true'
                                                    ... type Σ1..1CodeableConceptCategory or discipline
                                                    Binding: ?? (extensible): The type or discipline-style of the claim.

                                                    Σ1..1CodeableConceptCategory or discipline
                                                    Binding: ?? (extensible): The type or discipline-style of the claim.

                                                      ... subType 0..1CodeableConceptMore granular claim type
                                                      Binding: ?? (example): A more granular claim typecode.

                                                      0..1CodeableConceptMore granular claim type
                                                      Binding: ?? (example): A more granular claim typecode.

                                                        ... use Σ1..1codeclaim | preauthorization | predetermination
                                                        Binding: ?? (required): The purpose of the Claim: predetermination, preauthorization, claim.


                                                        Required Pattern: preauthorization
                                                        SΣ1..1codeclaim | preauthorization | predetermination
                                                        Binding: ?? (required): The purpose of the Claim: predetermination, preauthorization, claim.


                                                        Required Pattern: preauthorization
                                                        • Elements differ in definition for mustSupport: 'false' vs 'true'
                                                        ... patient Σ1..1Reference(PAS Beneficiary Patient)The recipient of the products and servicesSΣ1..1Reference(PAS Beneficiary Patient)The recipient of the products and services
                                                        • Elements differ in definition for mustSupport: 'false' vs 'true'
                                                        ... billablePeriod Σ0..1PeriodRelevant time frame for the claimΣ0..1PeriodRelevant time frame for the claim
                                                          ... created Σ1..1dateTimeResource creation dateΣ1..1dateTimeResource creation date
                                                            ... enterer 0..1Reference(Practitioner | PractitionerRole)Author of the claim0..1Reference(Practitioner | PractitionerRole)Author of the claim
                                                              ... insurer SΣ1..1Reference(PAS Insurer Organization)TargetSΣ1..1Reference(PAS Insurer Organization)Target
                                                                ... provider SΣ1..1Reference(PAS Requestor Organization | PAS PractitionerRole)Party responsible for the claimSΣ1..1Reference(PAS Requestor Organization | PAS PractitionerRole)Party responsible for the claim
                                                                  ... priority Σ1..1CodeableConceptDesired processing ugency
                                                                  Binding: ?? (example): The timeliness with which processing is required: stat, normal, deferred.

                                                                  Σ1..1CodeableConceptDesired processing ugency
                                                                  Binding: ?? (example): The timeliness with which processing is required: stat, normal, deferred.

                                                                    ... fundsReserve 0..1CodeableConceptFor whom to reserve funds
                                                                    Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None).

                                                                    0..1CodeableConceptFor whom to reserve funds
                                                                    Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None).

                                                                      ... related 0..*BackboneElementPrior or corollary claims
                                                                      0..0
                                                                      • Element maximum cardinalities differ: '2147483647' vs '0'
                                                                      .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                        .... extension 0..*ExtensionAdditional content defined by implementations
                                                                        0..*ExtensionAdditional content defined by implementations
                                                                          .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                          ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                            .... claim 0..1Reference(Claim)Reference to the related claim0..1Reference(Claim)Reference to the related claim
                                                                              .... relationship 0..1CodeableConceptHow the reference claim is related
                                                                              Binding: ?? (example): Relationship of this claim to a related Claim.

                                                                              0..1CodeableConceptHow the reference claim is related
                                                                              Binding: ?? (example): Relationship of this claim to a related Claim.

                                                                                .... reference 0..1IdentifierFile or case reference0..1IdentifierFile or case reference
                                                                                  ... prescription 0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Prescription authorizing services and products0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Prescription authorizing services and products
                                                                                    ... originalPrescription 0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Original prescription if superseded by fulfiller0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Original prescription if superseded by fulfiller
                                                                                      ... payee 0..1BackboneElementRecipient of benefits payable0..1BackboneElementRecipient of benefits payable
                                                                                        .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                          .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                          0..*ExtensionAdditional content defined by implementations
                                                                                            .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                            ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                              .... type 1..1CodeableConceptCategory of recipient
                                                                                              Binding: ?? (example): A code for the party to be reimbursed.

                                                                                              1..1CodeableConceptCategory of recipient
                                                                                              Binding: ?? (example): A code for the party to be reimbursed.

                                                                                                .... party 0..1Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson)Recipient reference0..1Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson)Recipient reference
                                                                                                  ... referral 0..1Reference(ServiceRequest)Treatment referral0..1Reference(ServiceRequest)Treatment referral
                                                                                                    ... facility 0..1Reference(Location)Servicing facility0..1Reference(Location)Servicing facility
                                                                                                      ... Slices for careTeam S0..*BackboneElementMembers of the care team
                                                                                                      Slice: Unordered, Open by value:extension('http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope').value as boolean
                                                                                                      S0..*BackboneElementMembers of the care team
                                                                                                      Slice: Unordered, Open by value:extension('http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope').value.ofType(boolean)
                                                                                                        .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                          .... Slices for extension 1..*ExtensionExtension
                                                                                                          Slice: Unordered, Open by value:url
                                                                                                          1..*ExtensionExtension
                                                                                                          Slice: Unordered, Open by value:url
                                                                                                            .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                            ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                              .... sequence S1..1positiveIntOrder of care teamS1..1positiveIntOrder of care team
                                                                                                                .... provider S1..1Reference(PAS Organization Base Profile | PAS PractitionerRole)Practitioner or organizationS1..1Reference(PAS Organization Base Profile | PAS PractitionerRole)Practitioner or organization
                                                                                                                  .... responsible 0..1booleanIndicator of the lead practitioner0..1booleanIndicator of the lead practitioner
                                                                                                                    .... role S0..1CodeableConceptFunction within the team
                                                                                                                    Binding: ?? (example): The role codes for the care team members.

                                                                                                                    S0..1CodeableConceptFunction within the team
                                                                                                                    Binding: ?? (example): The role codes for the care team members.

                                                                                                                      .... qualification S0..1CodeableConceptPractitioner credential or specialization
                                                                                                                      Binding: ?? (example): Provider professional qualifications.

                                                                                                                      S0..1CodeableConceptPractitioner credential or specialization
                                                                                                                      Binding: ?? (example): Provider professional qualifications.

                                                                                                                        ... Slices for supportingInfo S0..*BackboneElementSupporting information
                                                                                                                        Slice: Unordered, Open by value:category
                                                                                                                        S0..*BackboneElementSupporting information
                                                                                                                        Slice: Unordered, Open by value:category
                                                                                                                          .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                            .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                            0..*ExtensionAdditional content defined by implementations
                                                                                                                              .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                              ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                .... sequence S1..1positiveIntInformation instance identifierS1..1positiveIntInformation instance identifier
                                                                                                                                  .... category S1..1CodeableConceptClassification of the supplied information
                                                                                                                                  Binding: ?? (extensible)
                                                                                                                                  S1..1CodeableConceptClassification of the supplied information
                                                                                                                                  Binding: ?? (extensible)
                                                                                                                                    .... code 0..1CodeableConceptType of information
                                                                                                                                    Binding: ?? (example): The valuset used for additional information codes.

                                                                                                                                    0..1CodeableConceptType of information
                                                                                                                                    Binding: ?? (example): The valuset used for additional information codes.

                                                                                                                                      .... timing[x] 0..1date, PeriodWhen it occurred0..1date, PeriodWhen it occurred
                                                                                                                                        .... value[x] 0..1boolean, string, Quantity, Attachment, Reference(Resource)Data to be provided0..1boolean, string, Quantity, Attachment, Reference(Resource)Data to be provided
                                                                                                                                          .... reason 0..1CodeableConceptExplanation for the information
                                                                                                                                          Binding: ?? (example): Reason codes for the missing teeth.

                                                                                                                                          0..1CodeableConceptExplanation for the information
                                                                                                                                          Binding: ?? (example): Reason codes for the missing teeth.

                                                                                                                                            ... diagnosis S0..*BackboneElementPertinent diagnosis information. NOTE: Only the first 12 diagnoses can be sent in the X12 request.
                                                                                                                                            S0..*BackboneElementPertinent diagnosis information. NOTE: Only the first 12 diagnoses can be sent in the X12 request.
                                                                                                                                              .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                .... Slices for extension 0..*ExtensionExtension
                                                                                                                                                Slice: Unordered, Open by value:url
                                                                                                                                                0..*ExtensionExtension
                                                                                                                                                Slice: Unordered, Open by value:url
                                                                                                                                                  .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                  ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                    .... sequence S1..1positiveIntDiagnosis instance identifierS1..1positiveIntDiagnosis instance identifier
                                                                                                                                                      .... diagnosis[x] S1..1CodeableConceptNature of illness or problem
                                                                                                                                                      Binding: ?? (required)
                                                                                                                                                      S1..1CodeableConceptNature of illness or problem
                                                                                                                                                      Binding: ?? (required)
                                                                                                                                                        .... type S0..1CodeableConceptTiming or nature of the diagnosis
                                                                                                                                                        Binding: ?? (required)
                                                                                                                                                        S0..1CodeableConceptTiming or nature of the diagnosis
                                                                                                                                                        Binding: ?? (required)
                                                                                                                                                          .... onAdmission 0..1CodeableConceptPresent on admission
                                                                                                                                                          Binding: ?? (example): Present on admission.

                                                                                                                                                          0..1CodeableConceptPresent on admission
                                                                                                                                                          Binding: ?? (example): Present on admission.

                                                                                                                                                            .... packageCode 0..1CodeableConceptPackage billing code
                                                                                                                                                            Binding: ?? (example): The DRG codes associated with the diagnosis.

                                                                                                                                                            0..1CodeableConceptPackage billing code
                                                                                                                                                            Binding: ?? (example): The DRG codes associated with the diagnosis.

                                                                                                                                                              ... procedure 0..*BackboneElementClinical procedures performed
                                                                                                                                                              0..*BackboneElementClinical procedures performed
                                                                                                                                                                .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                  .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                  0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                    ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                      .... sequence 1..1positiveIntProcedure instance identifier1..1positiveIntProcedure instance identifier
                                                                                                                                                                        .... type 0..*CodeableConceptCategory of Procedure
                                                                                                                                                                        Binding: ?? (example): Example procedure type codes.


                                                                                                                                                                        0..*CodeableConceptCategory of Procedure
                                                                                                                                                                        Binding: ?? (example): Example procedure type codes.


                                                                                                                                                                          .... date 0..1dateTimeWhen the procedure was performed0..1dateTimeWhen the procedure was performed
                                                                                                                                                                            .... procedure[x] 1..1CodeableConcept, Reference(Procedure)Specific clinical procedure
                                                                                                                                                                            Binding: ?? (example): Example ICD10 Procedure codes.

                                                                                                                                                                            1..1CodeableConcept, Reference(Procedure)Specific clinical procedure
                                                                                                                                                                            Binding: ?? (example): Example ICD10 Procedure codes.

                                                                                                                                                                              .... udi 0..*Reference(Device)Unique device identifier
                                                                                                                                                                              0..*Reference(Device)Unique device identifier
                                                                                                                                                                                ... insurance SΣ1..*BackboneElementPatient insurance information
                                                                                                                                                                                SΣ1..*BackboneElementPatient insurance information
                                                                                                                                                                                  .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                    .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                    0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                      .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                      ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                        .... sequence SΣ1..1positiveIntInsurance instance identifierSΣ1..1positiveIntInsurance instance identifier
                                                                                                                                                                                          .... focal Σ1..1booleanCoverage to be used for adjudication
                                                                                                                                                                                          Required Pattern: true
                                                                                                                                                                                          Σ1..1booleanCoverage to be used for adjudication
                                                                                                                                                                                          Required Pattern: true
                                                                                                                                                                                            .... identifier 0..1IdentifierPre-assigned Claim number0..1IdentifierPre-assigned Claim number
                                                                                                                                                                                              .... coverage SΣ1..1Reference(PAS Coverage)Insurance informationSΣ1..1Reference(PAS Coverage)Insurance information
                                                                                                                                                                                                .... businessArrangement 0..1stringAdditional provider contract number0..1stringAdditional provider contract number
                                                                                                                                                                                                  .... preAuthRef 0..*stringPrior authorization reference number
                                                                                                                                                                                                  0..*stringPrior authorization reference number
                                                                                                                                                                                                    .... claimResponse 0..1Reference(ClaimResponse)Adjudication results0..1Reference(ClaimResponse)Adjudication results
                                                                                                                                                                                                      ... accident S0..1BackboneElementDetails of the eventS0..1BackboneElementDetails of the event
                                                                                                                                                                                                        .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                          .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                          0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                            .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                            ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                              .... date S1..1dateWhen the incident occurredSC1..1dateWhen the incident occurred
                                                                                                                                                                                                              FullDateRule: Dates need to be a full date - YYYY-MM-DD
                                                                                                                                                                                                                .... type S0..1CodeableConceptThe nature of the accident
                                                                                                                                                                                                                Binding: ?? (required): Codes identifying an accompanying cause of an illness, injury or an accident. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.

                                                                                                                                                                                                                S0..1CodeableConceptThe nature of the accident
                                                                                                                                                                                                                Binding: ?? (required): Codes identifying an accompanying cause of an illness, injury or an accident. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.

                                                                                                                                                                                                                  .... location[x] 0..1AddressWhere the event occurredS0..1AddressWhere the event occurred
                                                                                                                                                                                                                  • Elements differ in definition for mustSupport: 'false' vs 'true'
                                                                                                                                                                                                                  ... item S1..*BackboneElementProduct or service provided
                                                                                                                                                                                                                  SC1..*BackboneElementProduct or service provided
                                                                                                                                                                                                                  ImmediateLevelOfCare: If Certification Type is an immediate appeal, then Level of Service Code must be present
                                                                                                                                                                                                                    .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                      .... Slices for extension 0..*ExtensionExtension
                                                                                                                                                                                                                      Slice: Unordered, Open by value:url
                                                                                                                                                                                                                      2..*ExtensionExtension
                                                                                                                                                                                                                      Slice: Unordered, Open by value:url
                                                                                                                                                                                                                      • Element minimum cardinalities differ: '0' vs '2'
                                                                                                                                                                                                                      .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                      ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                        .... sequence S1..1positiveIntItem instance identifierS1..1positiveIntItem instance identifier
                                                                                                                                                                                                                          .... careTeamSequence S0..*positiveIntApplicable careTeam members
                                                                                                                                                                                                                          S0..*positiveIntApplicable careTeam members
                                                                                                                                                                                                                            .... diagnosisSequence S0..*positiveIntApplicable diagnoses
                                                                                                                                                                                                                            S0..*positiveIntApplicable diagnoses
                                                                                                                                                                                                                              .... procedureSequence 0..*positiveIntApplicable procedures
                                                                                                                                                                                                                              0..*positiveIntApplicable procedures
                                                                                                                                                                                                                                .... informationSequence S0..*positiveIntApplicable exception and supporting information
                                                                                                                                                                                                                                S0..*positiveIntApplicable exception and supporting information
                                                                                                                                                                                                                                  .... revenue S0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                  Binding: ?? (required)
                                                                                                                                                                                                                                  S0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                  Binding: ?? (required)
                                                                                                                                                                                                                                    .... category S1..1CodeableConceptSince PAS requests only have item-level information, a category is required for conformance with the X12 278 request.
                                                                                                                                                                                                                                    Binding: ?? (required): Codes identifying the classification of service. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.

                                                                                                                                                                                                                                    S1..1CodeableConceptSince PAS requests only have item-level information, a category is required for conformance with the X12 278 request.
                                                                                                                                                                                                                                    Binding: ?? (required): Codes identifying the classification of service. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.

                                                                                                                                                                                                                                      .... productOrService S1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                      Binding: ?? (required)
                                                                                                                                                                                                                                      S1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                      Binding: ?? (required)
                                                                                                                                                                                                                                        .... modifier S0..*CodeableConceptProduct or service billing modifiers
                                                                                                                                                                                                                                        Binding: ?? (required)
                                                                                                                                                                                                                                        S0..*CodeableConceptProduct or service billing modifiers
                                                                                                                                                                                                                                        Binding: ?? (required)
                                                                                                                                                                                                                                          .... programCode 0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                          Binding: ?? (example): Program specific reason codes.


                                                                                                                                                                                                                                          0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                          Binding: ?? (example): Program specific reason codes.


                                                                                                                                                                                                                                            .... serviced[x] S0..1date, PeriodDate or dates of service or product deliveryS0..1date, PeriodDate or dates of service or product delivery
                                                                                                                                                                                                                                            Slice: Unordered, Closed by type:$this
                                                                                                                                                                                                                                              .... location[x] S0..1CodeableConceptPlace of service or where product was supplied
                                                                                                                                                                                                                                              Binding: ?? (required)
                                                                                                                                                                                                                                              S1..1CodeableConceptPlace of service or where product was supplied
                                                                                                                                                                                                                                              Binding: ?? (required)
                                                                                                                                                                                                                                              • Element minimum cardinalities differ: '0' vs '1'
                                                                                                                                                                                                                                              .... quantity S0..1??Count of products or servicesSC0..1??A fixed quantity (no comparator)
                                                                                                                                                                                                                                              qty-3: If a code for the unit is present, the system SHALL also be present
                                                                                                                                                                                                                                              sqty-1: The comparator is not used on a SimpleQuantity
                                                                                                                                                                                                                                                .... unitPrice S0..1MoneyFee, charge or cost per itemS0..1MoneyFee, charge or cost per item
                                                                                                                                                                                                                                                  .... factor 0..1decimalPrice scaling factor0..1decimalPrice scaling factor
                                                                                                                                                                                                                                                    .... net 0..1MoneyTotal item cost0..1MoneyTotal item cost
                                                                                                                                                                                                                                                      .... udi 0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                      0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                        .... bodySite 0..1CodeableConceptAnatomical location
                                                                                                                                                                                                                                                        Binding: ?? (example): The code for the teeth, quadrant, sextant and arch.

                                                                                                                                                                                                                                                        0..1CodeableConceptAnatomical location
                                                                                                                                                                                                                                                        Binding: ?? (example): The code for the teeth, quadrant, sextant and arch.

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


                                                                                                                                                                                                                                                          0..*CodeableConceptAnatomical sub-location
                                                                                                                                                                                                                                                          Binding: ?? (example): The code for the tooth surface and surface combinations.


                                                                                                                                                                                                                                                            .... encounter 0..*Reference(Encounter)Encounters related to this billed item
                                                                                                                                                                                                                                                            0..*Reference(Encounter)Encounters related to this billed item
                                                                                                                                                                                                                                                              .... detail 0..*BackboneElementProduct or service provided
                                                                                                                                                                                                                                                              0..*BackboneElementProduct or service provided
                                                                                                                                                                                                                                                                ..... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                  ..... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                  0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                    ..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                    ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                      ..... sequence 1..1positiveIntItem instance identifier1..1positiveIntItem instance identifier
                                                                                                                                                                                                                                                                        ..... revenue 0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                        Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.

                                                                                                                                                                                                                                                                        0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                        Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.

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

                                                                                                                                                                                                                                                                          0..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                          Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.

                                                                                                                                                                                                                                                                            ..... productOrService 1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                            Binding: ?? (example): Allowable service and product codes.

                                                                                                                                                                                                                                                                            1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                            Binding: ?? (example): Allowable service and product codes.

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


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


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


                                                                                                                                                                                                                                                                                0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                                Binding: ?? (example): Program specific reason codes.


                                                                                                                                                                                                                                                                                  ..... quantity 0..1??Count of products or services0..1??Count of products or services
                                                                                                                                                                                                                                                                                    ..... unitPrice 0..1MoneyFee, charge or cost per item0..1MoneyFee, charge or cost per item
                                                                                                                                                                                                                                                                                      ..... factor 0..1decimalPrice scaling factor0..1decimalPrice scaling factor
                                                                                                                                                                                                                                                                                        ..... net 0..1MoneyTotal item cost0..1MoneyTotal item cost
                                                                                                                                                                                                                                                                                          ..... udi 0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                                          0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                                            ..... subDetail 0..*BackboneElementProduct or service provided
                                                                                                                                                                                                                                                                                            0..*BackboneElementProduct or service provided
                                                                                                                                                                                                                                                                                              ...... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                                                                                                                                                                                                                                ...... extension 0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                0..*ExtensionAdditional content defined by implementations
                                                                                                                                                                                                                                                                                                  ...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                  ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                                                                    ...... sequence 1..1positiveIntItem instance identifier1..1positiveIntItem instance identifier
                                                                                                                                                                                                                                                                                                      ...... revenue 0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                                                      Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.

                                                                                                                                                                                                                                                                                                      0..1CodeableConceptRevenue or cost center code
                                                                                                                                                                                                                                                                                                      Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.

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

                                                                                                                                                                                                                                                                                                        0..1CodeableConceptBenefit classification
                                                                                                                                                                                                                                                                                                        Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.

                                                                                                                                                                                                                                                                                                          ...... productOrService 1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                          Binding: ?? (example): Allowable service and product codes.

                                                                                                                                                                                                                                                                                                          1..1CodeableConceptBilling, service, product, or drug code
                                                                                                                                                                                                                                                                                                          Binding: ?? (example): Allowable service and product codes.

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


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


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


                                                                                                                                                                                                                                                                                                              0..*CodeableConceptProgram the product or service is provided under
                                                                                                                                                                                                                                                                                                              Binding: ?? (example): Program specific reason codes.


                                                                                                                                                                                                                                                                                                                ...... quantity 0..1??Count of products or services0..1??Count of products or services
                                                                                                                                                                                                                                                                                                                  ...... unitPrice 0..1MoneyFee, charge or cost per item0..1MoneyFee, charge or cost per item
                                                                                                                                                                                                                                                                                                                    ...... factor 0..1decimalPrice scaling factor0..1decimalPrice scaling factor
                                                                                                                                                                                                                                                                                                                      ...... net 0..1MoneyTotal item cost0..1MoneyTotal item cost
                                                                                                                                                                                                                                                                                                                        ...... udi 0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                                                                        0..*Reference(Device)Unique device identifier
                                                                                                                                                                                                                                                                                                                          ... total 0..1MoneyTotal claim cost0..1MoneyTotal claim cost

                                                                                                                                                                                                                                                                                                                            doco Documentation for this format