Moderne Patient:innenabrechnung und Datenkommunikation on FHIR (MOPED)
0.1.0 - ci-build

Moderne Patient:innenabrechnung und Datenkommunikation on FHIR (MOPED), published by ELGA GmbH. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7Austria/ELGA-MOPED-R5/ and changes regularly. See the Directory of published versions

## : PJ2LKFRequest1 - JSON Representation

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    {
      "resourceType" : "Claim",
      "id" : "PJ2LKFRequest1",
      "meta" : {
        "profile" : [
          🔗 "https://elga.moped.at/StructureDefinition/MopedLKFRequest"
        ]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim PJ2LKFRequest1</b></p><a name=\"PJ2LKFRequest1\"> </a><a name=\"hcPJ2LKFRequest1\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-MopedLKFRequest.html\">MOPED LKFRequest</a></p></div><p><b>Abrechnung - Knoten</b>: <a href=\"CodeSystem-LKFAbrechnungsKnotenCS.html#LKFAbrechnungsKnotenCS-C\">LKF Abrechnungsknoten: C</a> (C)</p><p><b>Fondsrelevanz</b>: <a href=\"CodeSystem-FondsrelevanzCS.html#FondsrelevanzCS-J\">Fondsrelevanz: J</a> (Ja (Abrechnung des stationären Aufenthalts/ambulanten Besuchs erfolgt über den Landesgesundheitsfonds/PRIKRAF))</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimTypeCS LKFREQ}\">LKF Request</span></p><p><b>subType</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimSubTypeCS LKFREQVORL}\">LKF Vorläufige Meldung</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: <a href=\"Patient-PJ2Patient.html\">Santiago Schnabeltier Test (official) Male, DoB: 1985-03-19 ( Social Security Number: 2873111374)</a></p><p><b>created</b>: 2025-02-24</p><p><b>insurer</b>: <a href=\"Organization-SV14.html\">Organization Österreichische Gesundheitskasse Oberösterreich</a></p><p><b>provider</b>: <a href=\"Organization-OrganizationKrankenhausRied.html\">Organization Krankenhaus der Barmherzigen Schwestern vom Hl. Vinzenz von Paul Ried</a></p><p><b>encounter</b>: </p><ul><li><a href=\"Encounter-PJ2Encounter.html\">Encounter: identifier = Visit number,Anonymous identifier; status = discharged; class = Stationär,akute stationäre Aufnahme/akuter ambulanter Besuch (ohne vorhergehende Terminvereinbarung); type = Moped Encounter; actualPeriod = 2024-08-08 08:21:00+0200 --&gt; 2024-08-12 19:22:00+0200</a></li><li><a href=\"Encounter-PJ2TransferEncounter5.html\">Encounter: status = completed; type = Moped Transfer Encounter; subjectStatus = physisch anwesend; actualPeriod = 2024-08-10 17:00:00+0200 --&gt; 2024-08-12 19:22:00+0200</a></li></ul><p><b>diagnosisRelatedGroup</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/LKFHauptdiagnosegruppenCS HDG15.03}\">Frakturen der unteren Extremität/Becken, außer Vorfuß</span></p><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 1</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS PLAUS}\">Plausibilitätskennzeichen</span></p><p><b>value</b>: 1234</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 2</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS ENDG}\">Endgültige Meldung</span></p><p><b>value</b>: false</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 3</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/ClaimSupportingInformationCategoryCS DEVX}\">XDok Device</span></p><p><b>value</b>: <a href=\"Device-XDokExampleDevice.html\">Device: status = active; category = Software; type = XDok</a></p></blockquote><blockquote><p><b>diagnosis</b></p><p><b>sequence</b>: 1</p><p><b>diagnosis</b>: <a href=\"Condition-PJ2Condition1.html\">Condition Fraktur der Patella</a></p><p><b>onAdmission</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-diagnosis-on-admission unknown}\">Unknown</span></p></blockquote><blockquote><p><b>diagnosis</b></p><p><b>sequence</b>: 2</p><p><b>diagnosis</b>: <a href=\"Condition-PJ2Condition2.html\">Condition Sonstige Ursachen exogener Noxen, nicht näher bezeichnet</a></p><p><b>onAdmission</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-diagnosis-on-admission unknown}\">Unknown</span></p></blockquote><blockquote><p><b>procedure</b></p><p><b>Medizinische Leistung - Abrechnungsrelevanz</b>: <a href=\"CodeSystem-AbrechnungsRelevanzCS.html#AbrechnungsRelevanzCS-J\">Abrechnungsrelevanz der medizinischen Leistung: J</a> (Ja (Die Leistung ist bei der Bepunktung zu berücksichtigen.))</p><p><b>sequence</b>: 1</p><p><b>procedure</b>: <a href=\"Procedure-PJ2Procedure1.html\">Procedure Physiotherapie im Rahmen eines stationären Aufenthaltes (LE=je Aufenthalt)</a></p></blockquote><blockquote><p><b>procedure</b></p><p><b>Medizinische Leistung - Abrechnungsrelevanz</b>: <a href=\"CodeSystem-AbrechnungsRelevanzCS.html#AbrechnungsRelevanzCS-J\">Abrechnungsrelevanz der medizinischen Leistung: J</a> (Ja (Die Leistung ist bei der Bepunktung zu berücksichtigen.))</p><p><b>sequence</b>: 2</p><p><b>procedure</b>: <a href=\"Procedure-PJ2Procedure2.html\">Procedure Polysomnographie im Schlaflabor (LE=je Behandlungstag)</a></p></blockquote><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Coverage-PJ2Coverage.html\">Coverage: identifier = urn:oid:1.2.40.0.10.1.4.3.9.1#FJK5MCDPMRCY; status = active; kind = insurance</a></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS SCULK}\">Punkte Belagsdauerausreißer nach unten – Leistungskomponente</span></p><p><b>quantity</b>: 0</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS SCUTK}\">Punkte Belagsdauerausreißer nach unten – Tageskomponente</span></p><p><b>quantity</b>: 0</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 3</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS BDZU}\">Zusatzpunkte Belagsdauerausreißer nach oben</span></p><p><b>quantity</b>: 0</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 4</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS INTZU}\">Zusatzpunkte Intensiv</span></p><p><b>quantity</b>: 0</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 5</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS MELZU}\">Zusatzpunkte Mehrfachleistungen</span></p><p><b>quantity</b>: 0</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 6</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS SCSPEZ}\">Punkte spezieller Bereiche (tageweise)</span></p><p><b>quantity</b>: 0</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 7</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS SCGES}\">Punkte total</span></p><p><b>quantity</b>: 1384</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 8</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS LDFPLK}\">Leistungskomponente/Leistungspunkte</span></p><p><b>quantity</b>: 62</p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 9</p><p><b>category</b>: <span title=\"Codes:{https://elga.moped.at/CodeSystem/MopedClaimItemCategoryCS LDFPTK}\">Tageskomponente/Kontaktpunktet</span></p><p><b>quantity</b>: 1322</p></blockquote></div>"
      },
      "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
          }
        }
      ]
    }