{ "resourceType" : "Claim", "id" : "PJ2LKFRequest1", "meta" : { "profile" : ["https://elga.moped.at/StructureDefinition/MopedLKFRequest"] }, "text" : { "status" : "extensions", "div" : "

Generated Narrative: Claim PJ2LKFRequest1

Profile: MOPED LKFRequest

Abrechnung - Knoten: LKF Abrechnungsknoten: C (C)

Fondsrelevanz: Fondsrelevanz: J (Ja (Abrechnung des stationären Aufenthalts/ambulanten Besuchs erfolgt über den Landesgesundheitsfonds/PRIKRAF))

status: Active

type: LKF Request

subType: LKF Vorläufige Meldung

use: Claim

patient: Santiago Schnabeltier Test (official) Male, DoB: 1985-03-19 ( Social Security Number: 2873111374)

created: 2025-02-24

insurer: Organization Österreichische Gesundheitskasse Oberösterreich

provider: Organization Krankenhaus der Barmherzigen Schwestern vom Hl. Vinzenz von Paul Ried

encounter:

diagnosisRelatedGroup: Frakturen der unteren Extremität/Becken, außer Vorfuß

supportingInfo

sequence: 1

category: Plausibilitätskennzeichen

value: 1234

supportingInfo

sequence: 2

category: Endgültige Meldung

value: false

supportingInfo

sequence: 3

category: XDok Device

value: Device: status = active; category = Software; type = XDok

diagnosis

sequence: 1

diagnosis: Condition Fraktur der Patella

onAdmission: Unknown

diagnosis

sequence: 2

diagnosis: Condition Sonstige Ursachen exogener Noxen, nicht näher bezeichnet

onAdmission: Unknown

procedure

Medizinische Leistung - Abrechnungsrelevanz: Abrechnungsrelevanz der medizinischen Leistung: J (Ja (Die Leistung ist bei der Bepunktung zu berücksichtigen.))

sequence: 1

procedure: Procedure Physiotherapie im Rahmen eines stationären Aufenthaltes (LE=je Aufenthalt)

procedure

Medizinische Leistung - Abrechnungsrelevanz: Abrechnungsrelevanz der medizinischen Leistung: J (Ja (Die Leistung ist bei der Bepunktung zu berücksichtigen.))

sequence: 2

procedure: Procedure Polysomnographie im Schlaflabor (LE=je Behandlungstag)

Insurances

-SequenceFocalCoverage
*1trueCoverage: identifier = urn:oid:1.2.40.0.10.1.4.3.9.1#FJK5MCDPMRCY; status = active; kind = insurance

item

sequence: 1

category: Punkte Belagsdauerausreißer nach unten – Leistungskomponente

quantity: 0

item

sequence: 2

category: Punkte Belagsdauerausreißer nach unten – Tageskomponente

quantity: 0

item

sequence: 3

category: Zusatzpunkte Belagsdauerausreißer nach oben

quantity: 0

item

sequence: 4

category: Zusatzpunkte Intensiv

quantity: 0

item

sequence: 5

category: Zusatzpunkte Mehrfachleistungen

quantity: 0

item

sequence: 6

category: Punkte spezieller Bereiche (tageweise)

quantity: 0

item

sequence: 7

category: Punkte total

quantity: 1384

item

sequence: 8

category: Leistungskomponente/Leistungspunkte

quantity: 62

item

sequence: 9

category: Tageskomponente/Kontaktpunktet

quantity: 1322

" }, "extension" : [{ "url" : "https://elga.moped.at/StructureDefinition/moped-ext-diagnoseKnoten", "valueCoding" : { "system" : "https://elga.moped.at/CodeSystem/LKFAbrechnungsKnotenCS", "code" : "C" } }, { "url" : "https://elga.moped.at/StructureDefinition/moped-ext-fondsrelevanz", "valueCoding" : { "system" : "https://elga.moped.at/CodeSystem/FondsrelevanzCS", "code" : "J" } }], "status" : "active", "type" : { "coding" : [{ "system" : "https://elga.moped.at/CodeSystem/MopedClaimTypeCS", "code" : "LKFREQ" }] }, "subType" : { "coding" : [{ "system" : "https://elga.moped.at/CodeSystem/MopedClaimSubTypeCS", "code" : "LKFREQVORL" }] }, "use" : "claim", "patient" : { "reference" : "Patient/PJ2Patient" }, "created" : "2025-02-24", "insurer" : { "reference" : "Organization/SV14" }, "provider" : { "reference" : "Organization/OrganizationKrankenhausRied" }, "encounter" : [{ "reference" : "Encounter/PJ2Encounter" }, { "reference" : "Encounter/PJ2TransferEncounter5" }], "diagnosisRelatedGroup" : { "coding" : [{ "system" : "https://elga.moped.at/CodeSystem/LKFHauptdiagnosegruppenCS", "code" : "HDG15.03" }] }, "supportingInfo" : [{ "sequence" : 1, "category" : { "coding" : [{ "system" : "https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS", "code" : "PLAUS" }] }, "valueString" : "1234" }, { "sequence" : 2, "category" : { "coding" : [{ "system" : "https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS", "code" : "ENDG" }] }, "valueBoolean" : false }, { "sequence" : 3, "category" : { "coding" : [{ "system" : "https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS", "code" : "DEVX" }] }, "valueReference" : { "reference" : "Device/XDokExampleDevice" } }], "diagnosis" : [{ "sequence" : 1, "diagnosisReference" : { "reference" : "Condition/PJ2Condition1" }, "onAdmission" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/ex-diagnosis-on-admission", "code" : "unknown" }] } }, { "sequence" : 2, "diagnosisReference" : { "reference" : "Condition/PJ2Condition2" }, "onAdmission" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/ex-diagnosis-on-admission", "code" : "unknown" }] } }], "procedure" : [{ "extension" : [{ "url" : "https://elga.moped.at/StructureDefinition/moped-ext-AbrechnungsRelevanz", "valueCoding" : { "system" : "https://elga.moped.at/CodeSystem/AbrechnungsRelevanzCS", "code" : "J" } }], "sequence" : 1, "procedureReference" : { "reference" : "Procedure/PJ2Procedure1" } }, { "extension" : [{ "url" : "https://elga.moped.at/StructureDefinition/moped-ext-AbrechnungsRelevanz", "valueCoding" : { "system" : "https://elga.moped.at/CodeSystem/AbrechnungsRelevanzCS", "code" : "J" } }], "sequence" : 2, "procedureReference" : { "reference" : "Procedure/PJ2Procedure2" } }], "insurance" : [{ "sequence" : 1, "focal" : true, "coverage" : { "reference" : "Coverage/PJ2Coverage" } }], "item" : [{ "sequence" : 1, "category" : { "coding" : [{ "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS", "code" : "SCULK" }] }, "quantity" : { "value" : 0 } }, { "sequence" : 2, "category" : { "coding" : [{ "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS", "code" : "SCUTK" }] }, "quantity" : { "value" : 0 } }, { "sequence" : 3, "category" : { "coding" : [{ "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS", "code" : "BDZU" }] }, "quantity" : { "value" : 0 } }, { "sequence" : 4, "category" : { "coding" : [{ "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS", "code" : "INTZU" }] }, "quantity" : { "value" : 0 } }, { "sequence" : 5, "category" : { "coding" : [{ "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS", "code" : "MELZU" }] }, "quantity" : { "value" : 0 } }, { "sequence" : 6, "category" : { "coding" : [{ "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS", "code" : "SCSPEZ" }] }, "quantity" : { "value" : 0 } }, { "sequence" : 7, "category" : { "coding" : [{ "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS", "code" : "SCGES" }] }, "quantity" : { "value" : 1384 } }, { "sequence" : 8, "category" : { "coding" : [{ "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS", "code" : "LDFPLK" }] }, "quantity" : { "value" : 62 } }, { "sequence" : 9, "category" : { "coding" : [{ "system" : "https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS", "code" : "LDFPTK" }] }, "quantity" : { "value" : 1322 } }] }