Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

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Extension: Subject To Medical Management

Context of Use

This extension may be used on the following element(s)

• Element ID: ExplanationOfBenefit.adjudication
• Element ID: ExplanationOfBenefit.item.adjudication

Usage info

Usages:

• Use this Extension: PCT Advanced EOB
• Examples for this Extension: Bundle/PCT-AEOB-Packet-1 and ExplanationOfBenefit/PCT-AEOB-1

You can also check for usages in the FHIR IG Statistics

Formal Views of Extension Content

Description Differentials, Snapshots, and other representations.

• Differential Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Extension

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..*	Extension	Subject To Medical Management
Extension.extension		0..0		Extension
Extension.url		1..1	uri	"http://hl7.org/fhir/us/davinci-pct/StructureDefinition/subjectToMedicalMgmt"
Extension.Slices for value[x]		1..1		The estimate may change subject to medical management with this reason Slice: Unordered, Open by type:$this Slicing Note: Other type slices that contain no new information are not shown in this view
Extension.Slices for value[x].valueString			string
Extension.Slices for value[x].valueCodeableConcept			CodeableConcept
Extension.Slices for value[x].value[x]:valueCodeableConcept		0..1	CodeableConcept	Value of extension Binding: Medical Management Type (extensible)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Extension.value[x]:valueCodeableConcept	Base	extensible	Medical Management Type	📦1.0.0	THO v7.1

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..*	Extension	Subject To Medical Management
Extension.id		0..1	string	Unique id for inter-element referencing
Extension.extension		0..0		Extension Slice: Unordered, Open by value:url
Extension.url		1..1	uri	"http://hl7.org/fhir/us/davinci-pct/StructureDefinition/subjectToMedicalMgmt"
Extension.Slices for value[x]		1..1		The estimate may change subject to medical management with this reason Slice: Unordered, Closed by type:$this Slicing Note: Other type slices that contain no new information are not shown in this view
Extension.Slices for value[x].valueString			string
Extension.Slices for value[x].valueCodeableConcept			CodeableConcept
Extension.Slices for value[x].value[x]:valueCodeableConcept		0..1	CodeableConcept	Value of extension Binding: Medical Management Type (extensible)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Extension.value[x]:valueCodeableConcept	Base	extensible	Medical Management Type	📦1.0.0	THO v7.1

Constraints

Id

Grade

Path(s)

Description

Expression

This structure is derived from Extension

Summary

Simple Extension with the type string, CodeableConcept: This extension is used to provide a reason to explain how the estimate may change subject to medical management.

Maturity: 2

Differential View

This structure is derived from Extension

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..*	Extension	Subject To Medical Management
Extension.extension		0..0		Extension
Extension.url		1..1	uri	"http://hl7.org/fhir/us/davinci-pct/StructureDefinition/subjectToMedicalMgmt"
Extension.Slices for value[x]		1..1		The estimate may change subject to medical management with this reason Slice: Unordered, Open by type:$this Slicing Note: Other type slices that contain no new information are not shown in this view
Extension.Slices for value[x].valueString			string
Extension.Slices for value[x].valueCodeableConcept			CodeableConcept
Extension.Slices for value[x].value[x]:valueCodeableConcept		0..1	CodeableConcept	Value of extension Binding: Medical Management Type (extensible)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Extension.value[x]:valueCodeableConcept	Base	extensible	Medical Management Type	📦1.0.0	THO v7.1

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..*	Extension	Subject To Medical Management
Extension.id		0..1	string	Unique id for inter-element referencing
Extension.extension		0..0		Extension Slice: Unordered, Open by value:url
Extension.url		1..1	uri	"http://hl7.org/fhir/us/davinci-pct/StructureDefinition/subjectToMedicalMgmt"
Extension.Slices for value[x]		1..1		The estimate may change subject to medical management with this reason Slice: Unordered, Closed by type:$this Slicing Note: Other type slices that contain no new information are not shown in this view
Extension.Slices for value[x].valueString			string
Extension.Slices for value[x].valueCodeableConcept			CodeableConcept
Extension.Slices for value[x].value[x]:valueCodeableConcept		0..1	CodeableConcept	Value of extension Binding: Medical Management Type (extensible)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Extension.value[x]:valueCodeableConcept	Base	extensible	Medical Management Type	📦1.0.0	THO v7.1

Constraints

Id

Grade

Path(s)

Description

Expression

This structure is derived from Extension

Summary

Simple Extension with the type string, CodeableConcept: This extension is used to provide a reason to explain how the estimate may change subject to medical management.

Maturity: 2

Other representations of profile: CSV, Excel, Schematron