臺灣健保事前審查實作指引
1.2.8 - ci-build
臺灣健保事前審查實作指引
1.2.8 - ci-build
臺灣健保事前審查實作指引, published by 衛生福利部中央健康保險署. This guide is not an authorized publication; it is the continuous build for version 1.2.8 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/TWNHIFHIR/pas/ and changes regularly. See the Directory of published versions
| Official URL: https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-twpas | Version: 1.2.8 | |||
| Active as of 2026-10-14 | Computable Name: ClaimTWPAS | |||
此癌藥事前審查-Claim TWPAS Profile說明本IG如何進一步定義FHIR的Claim Resource以呈現癌藥事前審查之內容
Usages:
You can also check for usages in the FHIR IG Statistics
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints Filter:  |
|---|---|---|---|---|
  Claim |
C | 0..* | Claim | Claim, Pre-determination or Pre-authorization Constraints: sequence-1, applType, supportingInfo, supportingInfo-tests, supportingInfo-c90-c91-c92 |
  id |
0..1 | id | 收件序號/案件編號，供案件追蹤與識別使用，醫院上傳時無須填寫。 | |
  meta |
1..1 | Meta | Metadata about the resource | |
 lastUpdated |
0..1 | instant | 上傳日期時間。供案件追蹤與識別使用，醫院上傳時無須填寫。 | |
 profile |
1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-twpas | |
| implicitRules |
0..1 | uri | A set of rules under which this content was created | |
 Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
  extension:encounter |
1..1 | Reference(就醫科別-Encounter TWPAS) | 就醫科別，為細分科之就醫科別，作為審查分科用。【此為參考Da Vinci PAS IG的extension設計】 URL: https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-claim-encounter | |
 modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |
 Slices for identifier |
0..* | Identifier | Business Identifier for claim Slice: Unordered, Open by value:use Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
 identifier:orig_file_name |
0..1 | Identifier | 原始檔名。供案件追蹤與識別使用，醫院上傳時無須填寫。 | |
  use |
1..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: usual | |
 identifier:old_acpt_no |
0..1 | Identifier | 原受理編號。院所上傳送核(subType = #1)案件時，不需填寫「原受理編號」資訊，受理成功後會由系統自動產生受理編號。當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。 | |
 use |
1..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: secondary | |
| status |
1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Required Pattern: active | |
| type |
1..1 | CodeableConcept | Category or discipline Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
 coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: institutional | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| subType |
1..1 | CodeableConcept | 申報類別，1:送核 | 2:送核補件 | 3:申復 | 4:爭議審議 | 5:申復補件 。院所上傳送核(subType = #1)案件時，不需填寫「原受理編號」資訊，受理成功後會由系統自動產生受理編號。當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier填寫原送核案件之受理編號。 Binding: NHI-健保事前審查-申報類別值集 (required) | |
 coding |
1..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-apply-type | |
| code |
1..1 | code | 申報類別，1:送核 | 2:送核補件 | 3:申復 | 4:爭議審議 | 5:申復補件 。當申報類別為2(送核補件)、3(申復)、4(爭議審議)、5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。 | |
| use |
1..1 | code | claim | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim. Required Pattern: preauthorization | |
 patient |
1..1 | Reference(病人資訊-Patient TWPAS) | 病人資訊 | |
| created |
1..1 | dateTime | 申請日期，YYYY-MM-DD，機構自填。健保署收案後另建受理日期，將呈現在ClaimResponse的disposition和created欄位。 | |
| enterer |
1..1 | Reference(醫事人員-Practitioner TWPAS) | 申請醫師，必須存在於醫事人員基本資料檔內，並於合約生效起迄日內。 | |
| provider |
1..1 | Reference(醫事機構-Organization TWPAS) | 醫事機構代碼，必須存在於醫事機構基本資料檔內。 | |
| priority |
1..1 | CodeableConcept | 申請案件類別，1:一般事前審查申請 | 3:自主審查 | 4:緊急報備；專審系統識別用，對應PXXT_CODE(TMHB,001)。 Binding: NHI-健保事前審查-申請案件類別值集 (required) | |
| Slices for supportingInfo |
2..* | BackboneElement | Supporting information Slice: Unordered, Closed by value:category Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
 supportingInfo:All Slices |
Content/Rules for all slices | |||
 modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | 因FHIR設計而必填、自動流水號（建議每次加1）、不得重複，作為每筆supportingInfo的唯一識別碼。最後一筆sequence號碼即表示總筆數。 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: NHI-健保事前審查-補充資訊類別值集 (required) | |
| supportingInfo:weight |
C | 1..1 | BackboneElement | 病人體重 Constraints: HTWT |
 modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
 category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
 id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: weight | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
 value[x] |
1..1 | Quantity | Data to be provided | |
| value |
1..1 | decimal | 體重，整數至多3位數及小數至多2位數。 | |
| comparator |
0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented. | |
| system |
C | 1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org |
| code |
1..1 | code | Coded form of the unit Required Pattern: kg | |
| supportingInfo:height |
C | 1..1 | BackboneElement | 病人身高 Constraints: HTWT |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: height | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Quantity | Data to be provided | |
| value |
1..1 | decimal | 身高(cm)，整數至多3位數及小數至多2位數。 | |
| comparator |
0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented. | |
| system |
C | 1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org |
| code |
1..1 | code | Coded form of the unit Required Pattern: cm | |
| supportingInfo:pregnancy |
0..1 | BackboneElement | 是否懷孕或哺乳 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: pregnancyBreastfeedingStatus | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | boolean | 是否懷孕或哺乳，false:未懷孕或哺乳 | true:有懷孕或哺乳 | |
| supportingInfo:imagingReport |
0..* | BackboneElement | 影像報告 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: imagingReport | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(影像報告-DiagnosticReport Image TWPAS) | 影像報告 | |
| supportingInfo:cancerStage |
0..* | BackboneElement | 癌症分期量表 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: cancerStage | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(癌症分期量表-Observation Cancer Stage TWPAS) | 癌症分期量表 | |
| supportingInfo:examinationReport |
0..* | BackboneElement | 檢查報告 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: examinationReport | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(檢查報告-DiagnosticReport TWPAS) | 檢查報告 | |
| supportingInfo:geneInfo |
0..* | BackboneElement | 基因資訊 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: geneInfo | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(基因資訊-Observation Diagnostic TWPAS) | 基因資訊 | |
| supportingInfo:tests |
0..* | BackboneElement | 檢驗(查) | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: tests | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(檢驗檢查-Observation Laboratory Result TWPAS) | 檢驗(查) | |
| supportingInfo:patientAssessment |
0..* | BackboneElement | 病人狀態評估 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: patientAssessment | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(病人狀態評估-Observation Patient Assessment TWPAS) | 病人狀態評估 | |
| supportingInfo:medicationRequest |
0..* | BackboneElement | 用藥品項 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: medicationRequest | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(用藥品項-MedicationRequest Treat TWPAS) | 用藥品項 | |
| supportingInfo:radiotherapy |
0..* | BackboneElement | 放射治療 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: radiotherapy | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(放射治療-Procedure TWPAS) | 放射治療 | |
| supportingInfo:carePlanDocument |
0..* | BackboneElement | 治療計畫文件，P-IO(免疫檢查點抑制劑治療計畫)、P-CART(CAR-T多團隊會議紀錄)、P-STEMCELL(造血幹細胞移植計畫書)，附件形式PDF | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: carePlanDocument | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(文件參照-DocumentReference TWPAS) | 治療計畫文件 | |
| supportingInfo:medicalRecord |
0..* | BackboneElement | 病歷資料（非屬影像報告檢查驗報告部分），可檢附其他佐證癌藥治療必要性之非結構化病歷。 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: medicalRecord | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(文件參照-DocumentReference TWPAS) | Data to be provided | |
| supportingInfo:treatmentAssessment |
0..* | BackboneElement | 結果資訊 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: treatmentAssessment | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(治療後疾病狀態評估-Observation Treatment Assessment TWPAS) | 結果資訊 | |
| supportingInfo:bloodgroup |
0..1 | BackboneElement | 血型 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: bloodgroup | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(血型-Observation Blood Group TWPAS) | 血型 | |
| supportingInfo:opd |
0..* | BackboneElement | 門診病歷 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: opd | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(門診病歷-Composition OPD TWPAS) | 門診病歷 | |
| supportingInfo:allergy |
0..* | BackboneElement | 過敏史 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: allergy | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(過敏史-AllergyIntolerance TWPAS) | 過敏史 | |
| diagnosis |
C | 1..* | BackboneElement | sequence=1時為主要疾病；sequence>=2代表共病。 Constraints: diagnosis |
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| extension:recordedDate |
0..* | date | 診斷日期，sequence=1時為必填，表示為用藥事前審查之主要疾病；其他共病不須填寫診斷日期。YYYY-MM-DD，西元年月日。【此為參考Da Vinci PAS IG的extension設計】 URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | sequence=1時為主要疾病；sequence>=2代表共病。 | |
| diagnosis[x] |
1..1 | CodeableConcept | 國際疾病分類代碼(含共病)，當前疾病狀態。ICD-10-CM。 Binding: 臺灣健保署2023年中文版ICD-10-CM值集 (preferred) | |
| Slices for coding |
0..* | Coding | Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:icd10-cm-2023 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2023年中文版ICD-10-CM值集 (extensible) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| coding:icd10-cm-2014 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2014年中文版ICD-10-CM值集 (extensible) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2014-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| type |
0..1 | CodeableConcept | Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. | |
| text |
C | 0..1 | string | 簡要病摘(申請理由)。連結院內HIS系統之簡要病摘，或填寫原事前審查之申請理由。請勿將醫事機構名稱、病人及醫師姓名等資訊列入結果中上傳，且不得包含HTML或XML等語法。 Constraints: pas-2 |
| procedure |
0..* | BackboneElement | Clinical procedures performed | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Procedure instance identifier | |
| date |
1..1 | dateTime | 手術(或其他處置)日期 | |
| procedure[x] |
1..1 | CodeableConcept | 手術(或其他處置)項目，經動脈導管肝臟腫瘤化學栓塞術(TACE)及冷凍療法等非屬手術。ICD-10-PCS 或 健保代碼 或 其他。 Binding: 臺灣健保署2023年中文版ICD-10-PCS值集 (preferred) | |
| Slices for coding |
1..1 | Coding | Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:icd10-pcs-2023 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2023年中文版ICD-10-PCS值集 (required) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2023-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| coding:icd10-pcs-2014 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2014年中文版ICD-10-PCS值集 (required) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2014-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| coding:medical-service-payment |
0..1 | Coding | Code defined by a terminology system Binding: NHI-健保事前審查-醫療服務給付項目值集 (required) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/medical-service-payment-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| insurance |
1..* | BackboneElement | Patient insurance information | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Insurance instance identifier Required Pattern: 1 | |
| focal |
1..1 | boolean | Coverage to be used for adjudication | |
| coverage |
1..1 | Reference(健保事前審查計畫-Coverage TWPAS) | Insurance information | |
| item |
1..* | BackboneElement | Product or service provided | |
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| extension:requestedService |
1..1 | Reference(事前審查品項-MedicationRequest Apply TWPAS) | 事前審查品項【此為參考Da Vinci PAS IG的extension設計】 URL: https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-requestedService | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Item instance identifier | |
| productOrService |
1..1 | CodeableConcept | 醫令類別 Binding: NHI-健保事前審查-醫令類別值集 (required) | |
| Slices for modifier |
1..2 | CodeableConcept | Product or service billing modifiers Slice: Unordered, Closed by value:coding.system Binding: ModifierTypeCodes (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. Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| modifier:continuation |
1..1 | CodeableConcept | 續用註記，1:初次使用 | 2:申請再次使用 Binding: NHI-健保事前審查-續用註記值集 (required) | |
| coding |
1..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status | |
| code |
1..1 | code | 1:初次使用 | 2:申請再次使用 | |
| modifier:lot |
0..1 | CodeableConcept | 用藥線別，0:不適用 | 1:第一線治療 | 2:第二線治療 | 3:第三線治療 | 4:第四線治療 | 5:第五線治療 Binding: NHI-健保事前審查-用藥線別值集 (required) | |
| coding |
1..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy | |
| code |
1..1 | code | 0:不適用 | 1:第一線治療 | 2:第二線治療 | 3:第三線治療 | 4:第四線治療 | 5:第五線治療 | |
| programCode |
C | 1..1 | CodeableConcept | 給付適應症條件，藥品給付規定內所規範之適應症或條件，若有特定事前審查品項代碼應以代碼填報。 Binding: ExampleProgramReasonCodes (example): Program specific reason codes. Constraints: pas-1 |
| coding |
0..1 | Coding | 給付適應症條件，當事前審查品項代碼為KC009612B5、KC010892B5、KC011112DE、KC011162B5、KC011362B5、KC01013229、KC01013230、KC01025219、KC01050238、KC01085229、KC00958229、JC00154261、KC01088229、KC01233224時，才可填寫。 Binding: NHI-健保事前審查-給付適應症值集 (required) | |
| text |
0..1 | string | 給付適應症條件，事前審查品項代碼不為KC009612B5、KC010892B5、KC011112DE、KC011162B5、KC011362B5、KC01013229、KC01013230、KC01025219、KC01050238、KC01085229、KC00958229、JC00154261、KC01088229、KC01233224時，請自行輸入文字。 | |
| quantity |
C | 1..1 | SimpleQuantity(4.0.1) | Count of products or services Binding: NHI-健保事前審查-藥品劑量單位及包裝類型值集 (required): 事前審查申請數量單位及包裝類型。 Constraints: sqty-1 |
| value |
1..1 | decimal | 事前審查申請數量 | |
| system |
C | 1..1 | uri | 事前審查申請數量單位及包裝類型之代碼系統 |
| code |
1..1 | code | 事前審查申請數量單位及包裝類型 | |
| bodySite |
0..1 | CodeableConcept | 申請部位，R:右側 | L:左側 | B:兩側。(此專案暫不檢核，未來待確認) Binding: NHI-健保事前審查-申請部位值集 (required) | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Claim.identifier:orig_file_name.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std. |
| Claim.identifier:old_acpt_no.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std. |
| Claim.status | Base | required | Financial Resource Status Codes | 📍4.0.1 | FHIR Std. |
| Claim.type | Base | extensible | Claim Type Codes | 📍4.0.1 | FHIR Std. |
| Claim.subType | Base | required | NHI-健保事前審查-申報類別值集 | 📦1.2.8 | This IG |
| Claim.use | Base | required | Use | 📍4.0.1 | FHIR Std. |
| Claim.priority | Base | required | NHI-健保事前審查-申請案件類別值集 | 📦1.2.8 | This IG |
| Claim.supportingInfo.category | Base | required | NHI-健保事前審查-補充資訊類別值集 | 📦1.2.8 | This IG |
| Claim.supportingInfo:weight.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:weight.value[x].comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:height.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:height.value[x].comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:pregnancy.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:imagingReport.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:cancerStage.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:examinationReport.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:geneInfo.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:tests.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:patientAssessment.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicationRequest.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:radiotherapy.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:carePlanDocument.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicalRecord.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:treatmentAssessment.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:bloodgroup.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:opd.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:allergy.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.diagnosis.diagnosis[x] | Base | preferred | 臺灣健保署2023年中文版ICD-10-CM值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023 | Base | extensible | 臺灣健保署2023年中文版ICD-10-CM值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014 | Base | extensible | 臺灣健保署2014年中文版ICD-10-CM值集 | 📦2017-07-19 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.type | Base | example | Example Diagnosis Type Codes | 📍4.0.1 | FHIR Std. |
| Claim.procedure.procedure[x] | Base | preferred | 臺灣健保署2023年中文版ICD-10-PCS值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:icd10-pcs-2023 | Base | required | 臺灣健保署2023年中文版ICD-10-PCS值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:icd10-pcs-2014 | Base | required | 臺灣健保署2014年中文版ICD-10-PCS值集 | 📦2017-07-19 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:medical-service-payment | Base | required | NHI-健保事前審查-醫療服務給付項目值集 | 📦1.2.8 | This IG |
| Claim.item.productOrService | Base | required | NHI-健保事前審查-醫令類別值集 | 📦1.2.8 | This IG |
| Claim.item.modifier | Base | example | Modifier type Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.modifier:continuation | Base | required | NHI-健保事前審查-續用註記值集 | 📦1.2.8 | This IG |
| Claim.item.modifier:lot | Base | required | NHI-健保事前審查-用藥線別值集 | 📦1.2.8 | This IG |
| Claim.item.programCode | Base | example | Example Program Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.programCode.coding | Base | required | NHI-健保事前審查-給付適應症值集 | 📦1.2.8 | This IG |
| Claim.item.quantity | Base | required | NHI-健保事前審查-藥品劑量單位及包裝類型值集 | 📦1.2.8 | This IG |
| Claim.item.bodySite | Base | required | NHI-健保事前審查-申請部位值集 | 📦1.2.8 | This IG |
| Id | Grade | Path(s) | Description | Expression |
| HTWT | error | Claim.supportingInfo:weight, Claim.supportingInfo:height | 整數至多3位數及小數至多2位數 |
value.ofType(Quantity).value < 1000 and ((value.ofType(Quantity).value * 100).round() / 100) = value.ofType(Quantity).value
|
| applType | error | Claim | 當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。目前IG僅針對申報類別為3(申復)進行檢核。 |
(subType.coding.exists(code='3')) implies (identifier.where(use = 'secondary').exists())
|
| diagnosis | error | Claim.diagnosis | diagnosis.sequence=1時才需填寫診斷日期、簡要病摘(申請原因) |
sequence=1 implies (extension.where(url = 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate').value.ofType(date).exists() and type.text.exists() )
|
| dom-2 | error | Claim | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | Claim | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | Claim | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | Claim | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | Claim | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| pas-1 | error | Claim.item.programCode | text、coding至少需存在一個。 |
text.exists() or coding.exists()
|
| pas-2 | error | Claim.diagnosis.type.text | 長度不得超過4000 bytes。 |
toString().length() <= 4000
|
| sequence-1 | error | Claim | diagnosis.sequence一定會有一個「1」，且只能出現一次。 |
diagnosis.where(sequence = 1).count() = 1
|
| sqty-1 | error | Claim.item.quantity | The comparator is not used on a SimpleQuantity |
comparator.empty()
|
| supportingInfo | error | Claim | 當Claim.priority(案件類別)為1(一般事前審查申請)、3(自主審查)時，至少還需提供檢查報告、影像報告、基因資訊中任一樣資訊。如果Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C61，且Claim.item.modifier:continuation(續用註記)為2，則可排除此條件。或Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C90、C91或C92，則可排除此條件。 |
(priority.coding.code.matches('1|3')) implies (supportingInfo.category.exists(coding.code = 'examinationReport') or supportingInfo.category.exists(coding.code = 'imagingReport') or supportingInfo.category.exists(coding.code = 'geneInfo') or (diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C61)')).exists() and item.modifier.where(coding.system = 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status').coding.exists(code = '2')) or (diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C90|C91|C92)')).exists()))
|
| supportingInfo-c90-c91-c92 | error | Claim | 當Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C90、C91或C92，需提供檢驗(查)、影像報告、基因資訊、檢驗檢查中任一項資訊。 |
(diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C90|C91|C92)')).exists()) implies (supportingInfo.category.exists(coding.code = 'tests') or supportingInfo.category.exists(coding.code = 'imagingReport') or supportingInfo.category.exists(coding.code = 'geneInfo') or supportingInfo.category.exists(coding.code = 'examinationReport'))
|
| supportingInfo-tests | error | Claim | 當Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C61，且Claim.item.modifier:continuation(續用註記)為2，需提供檢驗(查)。 |
(diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C61)')).exists() and (item.modifier.where(coding.system = 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status').coding.exists(code = '2'))) implies (supportingInfo.category.exists(coding.code = 'tests'))
|
This structure is derived from Claim
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Claim |
C | 0..* | Claim | Claim, Pre-determination or Pre-authorization Constraints: sequence-1, applType, supportingInfo, supportingInfo-tests, supportingInfo-c90-c91-c92 |
| id |
0..1 | id | 收件序號/案件編號，供案件追蹤與識別使用，醫院上傳時無須填寫。 | |
| meta |
1..1 | Meta | Metadata about the resource | |
| lastUpdated |
0..1 | instant | 上傳日期時間。供案件追蹤與識別使用，醫院上傳時無須填寫。 | |
| profile |
1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-twpas | |
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| extension:encounter |
1..1 | Reference(就醫科別-Encounter TWPAS) | 就醫科別，為細分科之就醫科別，作為審查分科用。【此為參考Da Vinci PAS IG的extension設計】 URL: https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-claim-encounter | |
| Slices for identifier |
0..* | Identifier | Business Identifier for claim Slice: Unordered, Open by value:use Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| identifier:orig_file_name |
0..1 | Identifier | 原始檔名。供案件追蹤與識別使用，醫院上傳時無須填寫。 | |
| use |
1..1 | code | usual | official | temp | secondary | old (If known) Required Pattern: usual | |
| identifier:old_acpt_no |
0..1 | Identifier | 原受理編號。院所上傳送核(subType = #1)案件時，不需填寫「原受理編號」資訊，受理成功後會由系統自動產生受理編號。當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。 | |
| use |
1..1 | code | usual | official | temp | secondary | old (If known) Required Pattern: secondary | |
| status |
1..1 | code | active | cancelled | draft | entered-in-error Required Pattern: active | |
| type |
1..1 | CodeableConcept | Category or discipline Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: institutional | |
| subType |
1..1 | CodeableConcept | 申報類別，1:送核 | 2:送核補件 | 3:申復 | 4:爭議審議 | 5:申復補件 。院所上傳送核(subType = #1)案件時，不需填寫「原受理編號」資訊，受理成功後會由系統自動產生受理編號。當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier填寫原送核案件之受理編號。 Binding: NHI-健保事前審查-申報類別值集 (required) | |
| coding |
1..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-apply-type | |
| code |
1..1 | code | 申報類別，1:送核 | 2:送核補件 | 3:申復 | 4:爭議審議 | 5:申復補件 。當申報類別為2(送核補件)、3(申復)、4(爭議審議)、5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。 | |
| use |
1..1 | code | claim | preauthorization | predetermination Required Pattern: preauthorization | |
| patient |
1..1 | Reference(病人資訊-Patient TWPAS) | 病人資訊 | |
| created |
1..1 | dateTime | 申請日期，YYYY-MM-DD，機構自填。健保署收案後另建受理日期，將呈現在ClaimResponse的disposition和created欄位。 | |
| enterer |
1..1 | Reference(醫事人員-Practitioner TWPAS) | 申請醫師，必須存在於醫事人員基本資料檔內，並於合約生效起迄日內。 | |
| provider |
1..1 | Reference(醫事機構-Organization TWPAS) | 醫事機構代碼，必須存在於醫事機構基本資料檔內。 | |
| priority |
1..1 | CodeableConcept | 申請案件類別，1:一般事前審查申請 | 3:自主審查 | 4:緊急報備；專審系統識別用，對應PXXT_CODE(TMHB,001)。 Binding: NHI-健保事前審查-申請案件類別值集 (required) | |
| Slices for supportingInfo |
2..* | BackboneElement | Supporting information Slice: Unordered, Closed by value:category Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| supportingInfo:All Slices |
Content/Rules for all slices | |||
| sequence |
1..1 | positiveInt | 因FHIR設計而必填、自動流水號（建議每次加1）、不得重複，作為每筆supportingInfo的唯一識別碼。最後一筆sequence號碼即表示總筆數。 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: NHI-健保事前審查-補充資訊類別值集 (required) | |
| supportingInfo:weight |
C | 1..1 | BackboneElement | 病人體重 Constraints: HTWT |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: weight | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Quantity | Data to be provided | |
| value |
1..1 | decimal | 體重，整數至多3位數及小數至多2位數。 | |
| system |
1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org | |
| code |
1..1 | code | Coded form of the unit Required Pattern: kg | |
| supportingInfo:height |
C | 1..1 | BackboneElement | 病人身高 Constraints: HTWT |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: height | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Quantity | Data to be provided | |
| value |
1..1 | decimal | 身高(cm)，整數至多3位數及小數至多2位數。 | |
| system |
1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org | |
| code |
1..1 | code | Coded form of the unit Required Pattern: cm | |
| supportingInfo:pregnancy |
0..1 | BackboneElement | 是否懷孕或哺乳 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: pregnancyBreastfeedingStatus | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | boolean | 是否懷孕或哺乳，false:未懷孕或哺乳 | true:有懷孕或哺乳 | |
| supportingInfo:imagingReport |
0..* | BackboneElement | 影像報告 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: imagingReport | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(影像報告-DiagnosticReport Image TWPAS) | 影像報告 | |
| supportingInfo:cancerStage |
0..* | BackboneElement | 癌症分期量表 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: cancerStage | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(癌症分期量表-Observation Cancer Stage TWPAS) | 癌症分期量表 | |
| supportingInfo:examinationReport |
0..* | BackboneElement | 檢查報告 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: examinationReport | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(檢查報告-DiagnosticReport TWPAS) | 檢查報告 | |
| supportingInfo:geneInfo |
0..* | BackboneElement | 基因資訊 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: geneInfo | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(基因資訊-Observation Diagnostic TWPAS) | 基因資訊 | |
| supportingInfo:tests |
0..* | BackboneElement | 檢驗(查) | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: tests | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(檢驗檢查-Observation Laboratory Result TWPAS) | 檢驗(查) | |
| supportingInfo:patientAssessment |
0..* | BackboneElement | 病人狀態評估 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: patientAssessment | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(病人狀態評估-Observation Patient Assessment TWPAS) | 病人狀態評估 | |
| supportingInfo:medicationRequest |
0..* | BackboneElement | 用藥品項 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: medicationRequest | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(用藥品項-MedicationRequest Treat TWPAS) | 用藥品項 | |
| supportingInfo:radiotherapy |
0..* | BackboneElement | 放射治療 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: radiotherapy | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(放射治療-Procedure TWPAS) | 放射治療 | |
| supportingInfo:carePlanDocument |
0..* | BackboneElement | 治療計畫文件，P-IO(免疫檢查點抑制劑治療計畫)、P-CART(CAR-T多團隊會議紀錄)、P-STEMCELL(造血幹細胞移植計畫書)，附件形式PDF | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: carePlanDocument | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(文件參照-DocumentReference TWPAS) | 治療計畫文件 | |
| supportingInfo:medicalRecord |
0..* | BackboneElement | 病歷資料（非屬影像報告檢查驗報告部分），可檢附其他佐證癌藥治療必要性之非結構化病歷。 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: medicalRecord | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(文件參照-DocumentReference TWPAS) | Data to be provided | |
| supportingInfo:treatmentAssessment |
0..* | BackboneElement | 結果資訊 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: treatmentAssessment | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(治療後疾病狀態評估-Observation Treatment Assessment TWPAS) | 結果資訊 | |
| supportingInfo:bloodgroup |
0..1 | BackboneElement | 血型 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: bloodgroup | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(血型-Observation Blood Group TWPAS) | 血型 | |
| supportingInfo:opd |
0..* | BackboneElement | 門診病歷 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: opd | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(門診病歷-Composition OPD TWPAS) | 門診病歷 | |
| supportingInfo:allergy |
0..* | BackboneElement | 過敏史 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: allergy | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(過敏史-AllergyIntolerance TWPAS) | 過敏史 | |
| diagnosis |
C | 1..* | BackboneElement | sequence=1時為主要疾病；sequence>=2代表共病。 Constraints: diagnosis |
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| extension:recordedDate |
0..* | date | 診斷日期，sequence=1時為必填，表示為用藥事前審查之主要疾病；其他共病不須填寫診斷日期。YYYY-MM-DD，西元年月日。【此為參考Da Vinci PAS IG的extension設計】 URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate | |
| sequence |
1..1 | positiveInt | sequence=1時為主要疾病；sequence>=2代表共病。 | |
| diagnosis[x] |
1..1 | CodeableConcept | 國際疾病分類代碼(含共病)，當前疾病狀態。ICD-10-CM。 Binding: 臺灣健保署2023年中文版ICD-10-CM值集 (preferred) | |
| Slices for coding |
0..* | Coding | Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:icd10-cm-2023 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2023年中文版ICD-10-CM值集 (extensible) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| coding:icd10-cm-2014 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2014年中文版ICD-10-CM值集 (extensible) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2014-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| type |
0..1 | CodeableConcept | Timing or nature of the diagnosis | |
| text |
C | 0..1 | string | 簡要病摘(申請理由)。連結院內HIS系統之簡要病摘，或填寫原事前審查之申請理由。請勿將醫事機構名稱、病人及醫師姓名等資訊列入結果中上傳，且不得包含HTML或XML等語法。 Constraints: pas-2 |
| procedure |
||||
| date |
1..1 | dateTime | 手術(或其他處置)日期 | |
| procedure[x] |
1..1 | CodeableConcept | 手術(或其他處置)項目，經動脈導管肝臟腫瘤化學栓塞術(TACE)及冷凍療法等非屬手術。ICD-10-PCS 或 健保代碼 或 其他。 Binding: 臺灣健保署2023年中文版ICD-10-PCS值集 (preferred) | |
| Slices for coding |
1..1 | Coding | Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:icd10-pcs-2023 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2023年中文版ICD-10-PCS值集 (required) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2023-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| coding:icd10-pcs-2014 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2014年中文版ICD-10-PCS值集 (required) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2014-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| coding:medical-service-payment |
0..1 | Coding | Code defined by a terminology system Binding: NHI-健保事前審查-醫療服務給付項目值集 (required) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/medical-service-payment-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| insurance |
||||
| sequence |
1..1 | positiveInt | Insurance instance identifier Required Pattern: 1 | |
| coverage |
1..1 | Reference(健保事前審查計畫-Coverage TWPAS) | Insurance information | |
| item |
1..* | BackboneElement | Product or service provided | |
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| extension:requestedService |
1..1 | Reference(事前審查品項-MedicationRequest Apply TWPAS) | 事前審查品項【此為參考Da Vinci PAS IG的extension設計】 URL: https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-requestedService | |
| productOrService |
1..1 | CodeableConcept | 醫令類別 Binding: NHI-健保事前審查-醫令類別值集 (required) | |
| Slices for modifier |
1..2 | CodeableConcept | Product or service billing modifiers Slice: Unordered, Closed by value:coding.system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| modifier:continuation |
1..1 | CodeableConcept | 續用註記，1:初次使用 | 2:申請再次使用 Binding: NHI-健保事前審查-續用註記值集 (required) | |
| coding |
1..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status | |
| code |
1..1 | code | 1:初次使用 | 2:申請再次使用 | |
| modifier:lot |
0..1 | CodeableConcept | 用藥線別，0:不適用 | 1:第一線治療 | 2:第二線治療 | 3:第三線治療 | 4:第四線治療 | 5:第五線治療 Binding: NHI-健保事前審查-用藥線別值集 (required) | |
| coding |
1..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy | |
| code |
1..1 | code | 0:不適用 | 1:第一線治療 | 2:第二線治療 | 3:第三線治療 | 4:第四線治療 | 5:第五線治療 | |
| programCode |
C | 1..1 | CodeableConcept | 給付適應症條件，藥品給付規定內所規範之適應症或條件，若有特定事前審查品項代碼應以代碼填報。 Constraints: pas-1 |
| coding |
0..1 | Coding | 給付適應症條件，當事前審查品項代碼為KC009612B5、KC010892B5、KC011112DE、KC011162B5、KC011362B5、KC01013229、KC01013230、KC01025219、KC01050238、KC01085229、KC00958229、JC00154261、KC01088229、KC01233224時，才可填寫。 Binding: NHI-健保事前審查-給付適應症值集 (required) | |
| text |
0..1 | string | 給付適應症條件，事前審查品項代碼不為KC009612B5、KC010892B5、KC011112DE、KC011162B5、KC011362B5、KC01013229、KC01013230、KC01025219、KC01050238、KC01085229、KC00958229、JC00154261、KC01088229、KC01233224時，請自行輸入文字。 | |
| quantity |
1..1 | SimpleQuantity(4.0.1) | Count of products or services Binding: NHI-健保事前審查-藥品劑量單位及包裝類型值集 (required): 事前審查申請數量單位及包裝類型。 | |
| value |
1..1 | decimal | 事前審查申請數量 | |
| system |
1..1 | uri | 事前審查申請數量單位及包裝類型之代碼系統 | |
| code |
1..1 | code | 事前審查申請數量單位及包裝類型 | |
| bodySite |
0..1 | CodeableConcept | 申請部位，R:右側 | L:左側 | B:兩側。(此專案暫不檢核，未來待確認) Binding: NHI-健保事前審查-申請部位值集 (required) | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Claim.subType | Base | required | NHI-健保事前審查-申報類別值集 | 📦1.2.8 | This IG |
| Claim.priority | Base | required | NHI-健保事前審查-申請案件類別值集 | 📦1.2.8 | This IG |
| Claim.supportingInfo.category | Base | required | NHI-健保事前審查-補充資訊類別值集 | 📦1.2.8 | This IG |
| Claim.diagnosis.diagnosis[x] | Base | preferred | 臺灣健保署2023年中文版ICD-10-CM值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023 | Base | extensible | 臺灣健保署2023年中文版ICD-10-CM值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014 | Base | extensible | 臺灣健保署2014年中文版ICD-10-CM值集 | 📦2017-07-19 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x] | Base | preferred | 臺灣健保署2023年中文版ICD-10-PCS值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:icd10-pcs-2023 | Base | required | 臺灣健保署2023年中文版ICD-10-PCS值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:icd10-pcs-2014 | Base | required | 臺灣健保署2014年中文版ICD-10-PCS值集 | 📦2017-07-19 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:medical-service-payment | Base | required | NHI-健保事前審查-醫療服務給付項目值集 | 📦1.2.8 | This IG |
| Claim.item.productOrService | Base | required | NHI-健保事前審查-醫令類別值集 | 📦1.2.8 | This IG |
| Claim.item.modifier:continuation | Base | required | NHI-健保事前審查-續用註記值集 | 📦1.2.8 | This IG |
| Claim.item.modifier:lot | Base | required | NHI-健保事前審查-用藥線別值集 | 📦1.2.8 | This IG |
| Claim.item.programCode.coding | Base | required | NHI-健保事前審查-給付適應症值集 | 📦1.2.8 | This IG |
| Claim.item.quantity | Base | required | NHI-健保事前審查-藥品劑量單位及包裝類型值集 | 📦1.2.8 | This IG |
| Claim.item.bodySite | Base | required | NHI-健保事前審查-申請部位值集 | 📦1.2.8 | This IG |
| Id | Grade | Path(s) | Description | Expression |
| HTWT | error | Claim.supportingInfo:weight, Claim.supportingInfo:height | 整數至多3位數及小數至多2位數 |
value.ofType(Quantity).value < 1000 and ((value.ofType(Quantity).value * 100).round() / 100) = value.ofType(Quantity).value
|
| applType | error | Claim | 當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。目前IG僅針對申報類別為3(申復)進行檢核。 |
(subType.coding.exists(code='3')) implies (identifier.where(use = 'secondary').exists())
|
| diagnosis | error | Claim.diagnosis | diagnosis.sequence=1時才需填寫診斷日期、簡要病摘(申請原因) |
sequence=1 implies (extension.where(url = 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate').value.ofType(date).exists() and type.text.exists() )
|
| pas-1 | error | Claim.item.programCode | text、coding至少需存在一個。 |
text.exists() or coding.exists()
|
| pas-2 | error | Claim.diagnosis.type.text | 長度不得超過4000 bytes。 |
toString().length() <= 4000
|
| sequence-1 | error | Claim | diagnosis.sequence一定會有一個「1」，且只能出現一次。 |
diagnosis.where(sequence = 1).count() = 1
|
| supportingInfo | error | Claim | 當Claim.priority(案件類別)為1(一般事前審查申請)、3(自主審查)時，至少還需提供檢查報告、影像報告、基因資訊中任一樣資訊。如果Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C61，且Claim.item.modifier:continuation(續用註記)為2，則可排除此條件。或Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C90、C91或C92，則可排除此條件。 |
(priority.coding.code.matches('1|3')) implies (supportingInfo.category.exists(coding.code = 'examinationReport') or supportingInfo.category.exists(coding.code = 'imagingReport') or supportingInfo.category.exists(coding.code = 'geneInfo') or (diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C61)')).exists() and item.modifier.where(coding.system = 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status').coding.exists(code = '2')) or (diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C90|C91|C92)')).exists()))
|
| supportingInfo-c90-c91-c92 | error | Claim | 當Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C90、C91或C92，需提供檢驗(查)、影像報告、基因資訊、檢驗檢查中任一項資訊。 |
(diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C90|C91|C92)')).exists()) implies (supportingInfo.category.exists(coding.code = 'tests') or supportingInfo.category.exists(coding.code = 'imagingReport') or supportingInfo.category.exists(coding.code = 'geneInfo') or supportingInfo.category.exists(coding.code = 'examinationReport'))
|
| supportingInfo-tests | error | Claim | 當Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C61，且Claim.item.modifier:continuation(續用註記)為2，需提供檢驗(查)。 |
(diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C61)')).exists() and (item.modifier.where(coding.system = 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status').coding.exists(code = '2'))) implies (supportingInfo.category.exists(coding.code = 'tests'))
|
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| Claim |
C | 0..* | Claim | Claim, Pre-determination or Pre-authorization Constraints: sequence-1, applType, supportingInfo, supportingInfo-tests, supportingInfo-c90-c91-c92 | ||||
| id |
0..1 | id | 收件序號/案件編號，供案件追蹤與識別使用，醫院上傳時無須填寫。 | |||||
| meta |
1..1 | Meta | Metadata about the resource | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| versionId |
0..1 | id | Version specific identifier | |||||
| lastUpdated |
0..1 | instant | 上傳日期時間。供案件追蹤與識別使用，醫院上傳時無須填寫。 | |||||
| source |
0..1 | uri | Identifies where the resource comes from | |||||
| profile |
1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-twpas | |||||
| security |
0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | |||||
| tag |
0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | |||||
| implicitRules |
0..1 | uri | A set of rules under which this content was created | |||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| extension:encounter |
1..1 | Reference(就醫科別-Encounter TWPAS) | 就醫科別，為細分科之就醫科別，作為審查分科用。【此為參考Da Vinci PAS IG的extension設計】 URL: https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-claim-encounter | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |||||
| Slices for identifier |
0..* | Identifier | Business Identifier for claim Slice: Unordered, Open by value:use Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| identifier:orig_file_name |
0..1 | Identifier | 原始檔名。供案件追蹤與識別使用，醫院上傳時無須填寫。 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use |
1..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: usual | |||||
| type |
0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | |||||
| system |
0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | |||||
| value |
0..1 | string | The value that is unique Example General: 123456 | |||||
| period |
0..1 | Period | Time period when id is/was valid for use | |||||
| assigner |
0..1 | Reference(Organization) | Organization that issued id (may be just text) | |||||
| identifier:old_acpt_no |
0..1 | Identifier | 原受理編號。院所上傳送核(subType = #1)案件時，不需填寫「原受理編號」資訊，受理成功後會由系統自動產生受理編號。當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use |
1..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: secondary | |||||
| type |
0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | |||||
| system |
0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | |||||
| value |
0..1 | string | The value that is unique Example General: 123456 | |||||
| period |
0..1 | Period | Time period when id is/was valid for use | |||||
| assigner |
0..1 | Reference(Organization) | Organization that issued id (may be just text) | |||||
| status |
1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Required Pattern: active | |||||
| type |
1..1 | CodeableConcept | Category or discipline Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: institutional | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| subType |
1..1 | CodeableConcept | 申報類別，1:送核 | 2:送核補件 | 3:申復 | 4:爭議審議 | 5:申復補件 。院所上傳送核(subType = #1)案件時，不需填寫「原受理編號」資訊，受理成功後會由系統自動產生受理編號。當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier填寫原送核案件之受理編號。 Binding: NHI-健保事前審查-申報類別值集 (required) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
1..1 | Coding | Code defined by a terminology system | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-apply-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | 申報類別，1:送核 | 2:送核補件 | 3:申復 | 4:爭議審議 | 5:申復補件 。當申報類別為2(送核補件)、3(申復)、4(爭議審議)、5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。 | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| use |
1..1 | code | claim | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim. Required Pattern: preauthorization | |||||
| patient |
1..1 | Reference(病人資訊-Patient TWPAS) | 病人資訊 | |||||
| billablePeriod |
0..1 | Period | Relevant time frame for the claim | |||||
| created |
1..1 | dateTime | 申請日期，YYYY-MM-DD，機構自填。健保署收案後另建受理日期，將呈現在ClaimResponse的disposition和created欄位。 | |||||
| enterer |
1..1 | Reference(醫事人員-Practitioner TWPAS) | 申請醫師，必須存在於醫事人員基本資料檔內，並於合約生效起迄日內。 | |||||
| insurer |
0..1 | Reference(Organization) | Target | |||||
| provider |
1..1 | Reference(醫事機構-Organization TWPAS) | 醫事機構代碼，必須存在於醫事機構基本資料檔內。 | |||||
| priority |
1..1 | CodeableConcept | 申請案件類別，1:一般事前審查申請 | 3:自主審查 | 4:緊急報備；專審系統識別用，對應PXXT_CODE(TMHB,001)。 Binding: NHI-健保事前審查-申請案件類別值集 (required) | |||||
| fundsReserve |
0..1 | CodeableConcept | For whom to reserve funds Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None). | |||||
| related |
0..* | BackboneElement | Prior or corollary claims | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| claim |
0..1 | Reference(Claim) | Reference to the related claim | |||||
| relationship |
0..1 | CodeableConcept | How the reference claim is related Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim. | |||||
| reference |
0..1 | Identifier | File or case reference | |||||
| prescription |
0..1 | Reference(DeviceRequest | MedicationRequest | VisionPrescription) | Prescription authorizing services and products | |||||
| originalPrescription |
0..1 | Reference(DeviceRequest | MedicationRequest | VisionPrescription) | Original prescription if superseded by fulfiller | |||||
| payee |
0..1 | BackboneElement | Recipient of benefits payable | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| type |
1..1 | CodeableConcept | Category of recipient Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed. | |||||
| party |
0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson) | Recipient reference | |||||
| referral |
0..1 | Reference(ServiceRequest) | Treatment referral | |||||
| facility |
0..1 | Reference(Location) | Servicing facility | |||||
| careTeam |
0..* | BackboneElement | Members of the care team | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Order of care team | |||||
| provider |
1..1 | Reference(Practitioner | PractitionerRole | Organization) | Practitioner or organization | |||||
| responsible |
0..1 | boolean | Indicator of the lead practitioner | |||||
| role |
0..1 | CodeableConcept | Function within the team Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members. | |||||
| qualification |
0..1 | CodeableConcept | Practitioner credential or specialization Binding: ExampleProviderQualificationCodes (example): Provider professional qualifications. | |||||
| Slices for supportingInfo |
2..* | BackboneElement | Supporting information Slice: Unordered, Closed by value:category Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| supportingInfo:All Slices |
Content/Rules for all slices | |||||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | 因FHIR設計而必填、自動流水號（建議每次加1）、不得重複，作為每筆supportingInfo的唯一識別碼。最後一筆sequence號碼即表示總筆數。 | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: NHI-健保事前審查-補充資訊類別值集 (required) | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
 timing[x] |
0..1 | When it occurred | ||||||
| timingDate |
date | |||||||
| timingPeriod |
Period | |||||||
| value[x] |
0..1 | Data to be provided | ||||||
| valueBoolean |
boolean | |||||||
| valueString |
string | |||||||
| valueQuantity |
Quantity | |||||||
| valueAttachment |
Attachment | |||||||
| valueReference |
Reference(Resource) | |||||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:weight |
C | 1..1 | BackboneElement | 病人體重 Constraints: HTWT | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: weight | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Quantity | Data to be provided | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| value |
1..1 | decimal | 體重，整數至多3位數及小數至多2位數。 | |||||
| comparator |
0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented. | |||||
| unit |
0..1 | string | Unit representation | |||||
| system |
C | 1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org | ||||
| code |
1..1 | code | Coded form of the unit Required Pattern: kg | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:height |
C | 1..1 | BackboneElement | 病人身高 Constraints: HTWT | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: height | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Quantity | Data to be provided | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| value |
1..1 | decimal | 身高(cm)，整數至多3位數及小數至多2位數。 | |||||
| comparator |
0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented. | |||||
| unit |
0..1 | string | Unit representation | |||||
| system |
C | 1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org | ||||
| code |
1..1 | code | Coded form of the unit Required Pattern: cm | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:pregnancy |
0..1 | BackboneElement | 是否懷孕或哺乳 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: pregnancyBreastfeedingStatus | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | boolean | 是否懷孕或哺乳，false:未懷孕或哺乳 | true:有懷孕或哺乳 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:imagingReport |
0..* | BackboneElement | 影像報告 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: imagingReport | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(影像報告-DiagnosticReport Image TWPAS) | 影像報告 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:cancerStage |
0..* | BackboneElement | 癌症分期量表 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: cancerStage | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(癌症分期量表-Observation Cancer Stage TWPAS) | 癌症分期量表 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:examinationReport |
0..* | BackboneElement | 檢查報告 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: examinationReport | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(檢查報告-DiagnosticReport TWPAS) | 檢查報告 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:geneInfo |
0..* | BackboneElement | 基因資訊 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: geneInfo | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(基因資訊-Observation Diagnostic TWPAS) | 基因資訊 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:tests |
0..* | BackboneElement | 檢驗(查) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: tests | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(檢驗檢查-Observation Laboratory Result TWPAS) | 檢驗(查) | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:patientAssessment |
0..* | BackboneElement | 病人狀態評估 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: patientAssessment | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(病人狀態評估-Observation Patient Assessment TWPAS) | 病人狀態評估 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:medicationRequest |
0..* | BackboneElement | 用藥品項 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: medicationRequest | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(用藥品項-MedicationRequest Treat TWPAS) | 用藥品項 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:radiotherapy |
0..* | BackboneElement | 放射治療 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: radiotherapy | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(放射治療-Procedure TWPAS) | 放射治療 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:carePlanDocument |
0..* | BackboneElement | 治療計畫文件，P-IO(免疫檢查點抑制劑治療計畫)、P-CART(CAR-T多團隊會議紀錄)、P-STEMCELL(造血幹細胞移植計畫書)，附件形式PDF | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: carePlanDocument | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(文件參照-DocumentReference TWPAS) | 治療計畫文件 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:medicalRecord |
0..* | BackboneElement | 病歷資料（非屬影像報告檢查驗報告部分），可檢附其他佐證癌藥治療必要性之非結構化病歷。 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: medicalRecord | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(文件參照-DocumentReference TWPAS) | Data to be provided | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:treatmentAssessment |
0..* | BackboneElement | 結果資訊 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: treatmentAssessment | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(治療後疾病狀態評估-Observation Treatment Assessment TWPAS) | 結果資訊 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:bloodgroup |
0..1 | BackboneElement | 血型 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: bloodgroup | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(血型-Observation Blood Group TWPAS) | 血型 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:opd |
0..* | BackboneElement | 門診病歷 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: opd | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(門診病歷-Composition OPD TWPAS) | 門診病歷 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:allergy |
0..* | BackboneElement | 過敏史 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: allergy | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(過敏史-AllergyIntolerance TWPAS) | 過敏史 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| diagnosis |
C | 1..* | BackboneElement | sequence=1時為主要疾病；sequence>=2代表共病。 Constraints: diagnosis | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| extension:recordedDate |
0..* | date | 診斷日期，sequence=1時為必填，表示為用藥事前審查之主要疾病；其他共病不須填寫診斷日期。YYYY-MM-DD，西元年月日。【此為參考Da Vinci PAS IG的extension設計】 URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | sequence=1時為主要疾病；sequence>=2代表共病。 | |||||
| diagnosis[x] |
1..1 | CodeableConcept | 國際疾病分類代碼(含共病)，當前疾病狀態。ICD-10-CM。 Binding: 臺灣健保署2023年中文版ICD-10-CM值集 (preferred) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| Slices for coding |
0..* | Coding | Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| coding:icd10-cm-2023 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2023年中文版ICD-10-CM值集 (extensible) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| coding:icd10-cm-2014 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2014年中文版ICD-10-CM值集 (extensible) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2014-tw | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| type |
0..1 | CodeableConcept | Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
0..* | Coding | Code defined by a terminology system | |||||
| text |
C | 0..1 | string | 簡要病摘(申請理由)。連結院內HIS系統之簡要病摘，或填寫原事前審查之申請理由。請勿將醫事機構名稱、病人及醫師姓名等資訊列入結果中上傳，且不得包含HTML或XML等語法。 Constraints: pas-2 | ||||
| onAdmission |
0..1 | CodeableConcept | Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission. | |||||
| packageCode |
0..1 | CodeableConcept | Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis. | |||||
| procedure |
0..* | BackboneElement | Clinical procedures performed | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Procedure instance identifier | |||||
| type |
0..* | CodeableConcept | Category of Procedure Binding: ExampleProcedureTypeCodes (example): Example procedure type codes. | |||||
| date |
1..1 | dateTime | 手術(或其他處置)日期 | |||||
| procedure[x] |
1..1 | CodeableConcept | 手術(或其他處置)項目，經動脈導管肝臟腫瘤化學栓塞術(TACE)及冷凍療法等非屬手術。ICD-10-PCS 或 健保代碼 或 其他。 Binding: 臺灣健保署2023年中文版ICD-10-PCS值集 (preferred) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| Slices for coding |
1..1 | Coding | Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| coding:icd10-pcs-2023 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2023年中文版ICD-10-PCS值集 (required) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2023-tw | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| coding:icd10-pcs-2014 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2014年中文版ICD-10-PCS值集 (required) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2014-tw | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| coding:medical-service-payment |
0..1 | Coding | Code defined by a terminology system Binding: NHI-健保事前審查-醫療服務給付項目值集 (required) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/medical-service-payment-tw | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| udi |
0..* | Reference(Device) | Unique device identifier | |||||
| insurance |
1..* | BackboneElement | Patient insurance information | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Insurance instance identifier Required Pattern: 1 | |||||
| focal |
1..1 | boolean | Coverage to be used for adjudication | |||||
| identifier |
0..1 | Identifier | Pre-assigned Claim number | |||||
| coverage |
1..1 | Reference(健保事前審查計畫-Coverage TWPAS) | Insurance information | |||||
| businessArrangement |
0..1 | string | Additional provider contract number | |||||
| preAuthRef |
0..* | string | Prior authorization reference number | |||||
| claimResponse |
0..1 | Reference(ClaimResponse) | Adjudication results | |||||
| accident |
0..1 | BackboneElement | Details of the event | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| date |
1..1 | date | When the incident occurred | |||||
| type |
0..1 | CodeableConcept | The nature of the accident Binding: ActIncidentCode (extensible): Type of accident: work place, auto, etc. | |||||
| location[x] |
0..1 | Where the event occurred | ||||||
| locationAddress |
Address | |||||||
| locationReference |
Reference(Location) | |||||||
| item |
1..* | BackboneElement | Product or service provided | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| extension:requestedService |
1..1 | Reference(事前審查品項-MedicationRequest Apply TWPAS) | 事前審查品項【此為參考Da Vinci PAS IG的extension設計】 URL: https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-requestedService | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Item instance identifier | |||||
| careTeamSequence |
0..* | positiveInt | Applicable careTeam members | |||||
| diagnosisSequence |
0..* | positiveInt | Applicable diagnoses | |||||
| procedureSequence |
0..* | positiveInt | Applicable procedures | |||||
| informationSequence |
0..* | positiveInt | Applicable exception and supporting information | |||||
| revenue |
0..1 | CodeableConcept | Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products. | |||||
| category |
0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses. | |||||
| productOrService |
1..1 | CodeableConcept | 醫令類別 Binding: NHI-健保事前審查-醫令類別值集 (required) | |||||
| Slices for modifier |
1..2 | CodeableConcept | Product or service billing modifiers Slice: Unordered, Closed by value:coding.system Binding: ModifierTypeCodes (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. Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| modifier:continuation |
1..1 | CodeableConcept | 續用註記，1:初次使用 | 2:申請再次使用 Binding: NHI-健保事前審查-續用註記值集 (required) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
1..1 | Coding | Code defined by a terminology system | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | 1:初次使用 | 2:申請再次使用 | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| modifier:lot |
0..1 | CodeableConcept | 用藥線別，0:不適用 | 1:第一線治療 | 2:第二線治療 | 3:第三線治療 | 4:第四線治療 | 5:第五線治療 Binding: NHI-健保事前審查-用藥線別值集 (required) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
1..1 | Coding | Code defined by a terminology system | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | 0:不適用 | 1:第一線治療 | 2:第二線治療 | 3:第三線治療 | 4:第四線治療 | 5:第五線治療 | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| programCode |
C | 1..1 | CodeableConcept | 給付適應症條件，藥品給付規定內所規範之適應症或條件，若有特定事前審查品項代碼應以代碼填報。 Binding: ExampleProgramReasonCodes (example): Program specific reason codes. Constraints: pas-1 | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
0..1 | Coding | 給付適應症條件，當事前審查品項代碼為KC009612B5、KC010892B5、KC011112DE、KC011162B5、KC011362B5、KC01013229、KC01013230、KC01025219、KC01050238、KC01085229、KC00958229、JC00154261、KC01088229、KC01233224時，才可填寫。 Binding: NHI-健保事前審查-給付適應症值集 (required) | |||||
| text |
0..1 | string | 給付適應症條件，事前審查品項代碼不為KC009612B5、KC010892B5、KC011112DE、KC011162B5、KC011362B5、KC01013229、KC01013230、KC01025219、KC01050238、KC01085229、KC00958229、JC00154261、KC01088229、KC01233224時，請自行輸入文字。 | |||||
| serviced[x] |
0..1 | Date or dates of service or product delivery | ||||||
| servicedDate |
date | |||||||
| servicedPeriod |
Period | |||||||
| location[x] |
0..1 | Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc. | ||||||
| locationCodeableConcept |
CodeableConcept | |||||||
| locationAddress |
Address | |||||||
| locationReference |
Reference(Location) | |||||||
| quantity |
C | 1..1 | SimpleQuantity(4.0.1) | Count of products or services Binding: NHI-健保事前審查-藥品劑量單位及包裝類型值集 (required): 事前審查申請數量單位及包裝類型。 Constraints: sqty-1 | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| value |
1..1 | decimal | 事前審查申請數量 | |||||
| unit |
0..1 | string | Unit representation | |||||
| system |
C | 1..1 | uri | 事前審查申請數量單位及包裝類型之代碼系統 | ||||
| code |
1..1 | code | 事前審查申請數量單位及包裝類型 | |||||
| unitPrice |
0..1 | Money | Fee, charge or cost per item | |||||
| factor |
0..1 | decimal | Price scaling factor | |||||
| net |
0..1 | Money | Total item cost | |||||
| udi |
0..* | Reference(Device) | Unique device identifier | |||||
| bodySite |
0..1 | CodeableConcept | 申請部位，R:右側 | L:左側 | B:兩側。(此專案暫不檢核，未來待確認) Binding: NHI-健保事前審查-申請部位值集 (required) | |||||
| subSite |
0..* | CodeableConcept | Anatomical sub-location Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations. | |||||
| encounter |
0..* | Reference(Encounter) | Encounters related to this billed item | |||||
| detail |
0..* | BackboneElement | Product or service provided | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Item instance identifier | |||||
| revenue |
0..1 | CodeableConcept | Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products. | |||||
| category |
0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses. | |||||
| productOrService |
1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |||||
| modifier |
0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (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..* | CodeableConcept | Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes. | |||||
| quantity |
C | 0..1 | SimpleQuantity(4.0.1) | Count of products or services Constraints: sqty-1 | ||||
| unitPrice |
0..1 | Money | Fee, charge or cost per item | |||||
| factor |
0..1 | decimal | Price scaling factor | |||||
| net |
0..1 | Money | Total item cost | |||||
| udi |
0..* | Reference(Device) | Unique device identifier | |||||
| subDetail |
0..* | BackboneElement | Product or service provided | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Item instance identifier | |||||
| revenue |
0..1 | CodeableConcept | Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products. | |||||
| category |
0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses. | |||||
| productOrService |
1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |||||
| modifier |
0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (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..* | CodeableConcept | Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes. | |||||
| quantity |
C | 0..1 | SimpleQuantity(4.0.1) | Count of products or services Constraints: sqty-1 | ||||
| unitPrice |
0..1 | Money | Fee, charge or cost per item | |||||
| factor |
0..1 | decimal | Price scaling factor | |||||
| net |
0..1 | Money | Total item cost | |||||
| udi |
0..* | Reference(Device) | Unique device identifier | |||||
| total |
0..1 | Money | Total claim cost | |||||
| Documentation for this format | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| Claim.meta.security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std. |
| Claim.meta.tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std. |
| Claim.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| Claim.identifier:orig_file_name.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std. |
| Claim.identifier:orig_file_name.type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std. |
| Claim.identifier:old_acpt_no.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std. |
| Claim.identifier:old_acpt_no.type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std. |
| Claim.status | Base | required | Financial Resource Status Codes | 📍4.0.1 | FHIR Std. |
| Claim.type | Base | extensible | Claim Type Codes | 📍4.0.1 | FHIR Std. |
| Claim.subType | Base | required | NHI-健保事前審查-申報類別值集 | 📦1.2.8 | This IG |
| Claim.use | Base | required | Use | 📍4.0.1 | FHIR Std. |
| Claim.priority | Base | required | NHI-健保事前審查-申請案件類別值集 | 📦1.2.8 | This IG |
| Claim.fundsReserve | Base | example | FundsReserve | 📍4.0.1 | FHIR Std. |
| Claim.related.relationship | Base | example | Example Related Claim Relationship Codes | 📍4.0.1 | FHIR Std. |
| Claim.payee.type | Base | example | PayeeType | 📍4.0.1 | FHIR Std. |
| Claim.careTeam.role | Base | example | Claim Care Team Role Codes | 📍4.0.1 | FHIR Std. |
| Claim.careTeam.qualification | Base | example | Example Provider Qualification Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo.category | Base | required | NHI-健保事前審查-補充資訊類別值集 | 📦1.2.8 | This IG |
| Claim.supportingInfo.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:weight.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:weight.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:weight.value[x].comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:weight.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:height.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:height.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:height.value[x].comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:height.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:pregnancy.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:pregnancy.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:pregnancy.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:imagingReport.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:imagingReport.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:imagingReport.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:cancerStage.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:cancerStage.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:cancerStage.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:examinationReport.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:examinationReport.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:examinationReport.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:geneInfo.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:geneInfo.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:geneInfo.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:tests.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:tests.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:tests.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:patientAssessment.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:patientAssessment.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:patientAssessment.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicationRequest.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicationRequest.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicationRequest.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:radiotherapy.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:radiotherapy.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:radiotherapy.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:carePlanDocument.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:carePlanDocument.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:carePlanDocument.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicalRecord.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicalRecord.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicalRecord.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:treatmentAssessment.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:treatmentAssessment.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:treatmentAssessment.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:bloodgroup.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:bloodgroup.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:bloodgroup.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:opd.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:opd.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:opd.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:allergy.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:allergy.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:allergy.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.diagnosis.diagnosis[x] | Base | preferred | 臺灣健保署2023年中文版ICD-10-CM值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023 | Base | extensible | 臺灣健保署2023年中文版ICD-10-CM值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014 | Base | extensible | 臺灣健保署2014年中文版ICD-10-CM值集 | 📦2017-07-19 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.type | Base | example | Example Diagnosis Type Codes | 📍4.0.1 | FHIR Std. |
| Claim.diagnosis.onAdmission | Base | example | Example Diagnosis on Admission Codes | 📍4.0.1 | FHIR Std. |
| Claim.diagnosis.packageCode | Base | example | Example Diagnosis Related Group Codes | 📍4.0.1 | FHIR Std. |
| Claim.procedure.type | Base | example | Example Procedure Type Codes | 📍4.0.1 | FHIR Std. |
| Claim.procedure.procedure[x] | Base | preferred | 臺灣健保署2023年中文版ICD-10-PCS值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:icd10-pcs-2023 | Base | required | 臺灣健保署2023年中文版ICD-10-PCS值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:icd10-pcs-2014 | Base | required | 臺灣健保署2014年中文版ICD-10-PCS值集 | 📦2017-07-19 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:medical-service-payment | Base | required | NHI-健保事前審查-醫療服務給付項目值集 | 📦1.2.8 | This IG |
| Claim.accident.type | Base | extensible | ActIncidentCode | 📦3.0.0 | THO v7.4 |
| Claim.item.revenue | Base | example | Example Revenue Center Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.category | Base | example | Benefit Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.productOrService | Base | required | NHI-健保事前審查-醫令類別值集 | 📦1.2.8 | This IG |
| Claim.item.modifier | Base | example | Modifier type Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.modifier:continuation | Base | required | NHI-健保事前審查-續用註記值集 | 📦1.2.8 | This IG |
| Claim.item.modifier:lot | Base | required | NHI-健保事前審查-用藥線別值集 | 📦1.2.8 | This IG |
| Claim.item.programCode | Base | example | Example Program Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.programCode.coding | Base | required | NHI-健保事前審查-給付適應症值集 | 📦1.2.8 | This IG |
| Claim.item.location[x] | Base | example | Example Service Place Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.quantity | Base | required | NHI-健保事前審查-藥品劑量單位及包裝類型值集 | 📦1.2.8 | This IG |
| Claim.item.bodySite | Base | required | NHI-健保事前審查-申請部位值集 | 📦1.2.8 | This IG |
| Claim.item.subSite | Base | example | Surface Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.revenue | Base | example | Example Revenue Center Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.category | Base | example | Benefit Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.productOrService | Base | example | USCLS Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.modifier | Base | example | Modifier type Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.programCode | Base | example | Example Program Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.subDetail.revenue | Base | example | Example Revenue Center Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.subDetail.category | Base | example | Benefit Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.subDetail.productOrService | Base | example | USCLS Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.subDetail.modifier | Base | example | Modifier type Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.subDetail.programCode | Base | example | Example Program Reason Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| HTWT | error | Claim.supportingInfo:weight, Claim.supportingInfo:height | 整數至多3位數及小數至多2位數 |
value.ofType(Quantity).value < 1000 and ((value.ofType(Quantity).value * 100).round() / 100) = value.ofType(Quantity).value
|
| applType | error | Claim | 當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。目前IG僅針對申報類別為3(申復)進行檢核。 |
(subType.coding.exists(code='3')) implies (identifier.where(use = 'secondary').exists())
|
| diagnosis | error | Claim.diagnosis | diagnosis.sequence=1時才需填寫診斷日期、簡要病摘(申請原因) |
sequence=1 implies (extension.where(url = 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate').value.ofType(date).exists() and type.text.exists() )
|
| dom-2 | error | Claim | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | Claim | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | Claim | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | Claim | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | Claim | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| pas-1 | error | Claim.item.programCode | text、coding至少需存在一個。 |
text.exists() or coding.exists()
|
| pas-2 | error | Claim.diagnosis.type.text | 長度不得超過4000 bytes。 |
toString().length() <= 4000
|
| sequence-1 | error | Claim | diagnosis.sequence一定會有一個「1」，且只能出現一次。 |
diagnosis.where(sequence = 1).count() = 1
|
| sqty-1 | error | Claim.item.quantity, Claim.item.detail.quantity, Claim.item.detail.subDetail.quantity | The comparator is not used on a SimpleQuantity |
comparator.empty()
|
| supportingInfo | error | Claim | 當Claim.priority(案件類別)為1(一般事前審查申請)、3(自主審查)時，至少還需提供檢查報告、影像報告、基因資訊中任一樣資訊。如果Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C61，且Claim.item.modifier:continuation(續用註記)為2，則可排除此條件。或Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C90、C91或C92，則可排除此條件。 |
(priority.coding.code.matches('1|3')) implies (supportingInfo.category.exists(coding.code = 'examinationReport') or supportingInfo.category.exists(coding.code = 'imagingReport') or supportingInfo.category.exists(coding.code = 'geneInfo') or (diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C61)')).exists() and item.modifier.where(coding.system = 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status').coding.exists(code = '2')) or (diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C90|C91|C92)')).exists()))
|
| supportingInfo-c90-c91-c92 | error | Claim | 當Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C90、C91或C92，需提供檢驗(查)、影像報告、基因資訊、檢驗檢查中任一項資訊。 |
(diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C90|C91|C92)')).exists()) implies (supportingInfo.category.exists(coding.code = 'tests') or supportingInfo.category.exists(coding.code = 'imagingReport') or supportingInfo.category.exists(coding.code = 'geneInfo') or supportingInfo.category.exists(coding.code = 'examinationReport'))
|
| supportingInfo-tests | error | Claim | 當Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C61，且Claim.item.modifier:continuation(續用註記)為2，需提供檢驗(查)。 |
(diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C61)')).exists() and (item.modifier.where(coding.system = 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status').coding.exists(code = '2'))) implies (supportingInfo.category.exists(coding.code = 'tests'))
|
This structure is derived from Claim
Summary
Mandatory: 33 elements(32 nested mandatory elements)
Must-Support: 56 elements
Prohibited: 17 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Claim |
C | 0..* | Claim | Claim, Pre-determination or Pre-authorization Constraints: sequence-1, applType, supportingInfo, supportingInfo-tests, supportingInfo-c90-c91-c92 |
| id |
0..1 | id | 收件序號/案件編號，供案件追蹤與識別使用，醫院上傳時無須填寫。 | |
| meta |
1..1 | Meta | Metadata about the resource | |
| lastUpdated |
0..1 | instant | 上傳日期時間。供案件追蹤與識別使用，醫院上傳時無須填寫。 | |
| profile |
1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-twpas | |
| implicitRules |
0..1 | uri | A set of rules under which this content was created | |
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| extension:encounter |
1..1 | Reference(就醫科別-Encounter TWPAS) | 就醫科別，為細分科之就醫科別，作為審查分科用。【此為參考Da Vinci PAS IG的extension設計】 URL: https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-claim-encounter | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |
| Slices for identifier |
0..* | Identifier | Business Identifier for claim Slice: Unordered, Open by value:use Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| identifier:orig_file_name |
0..1 | Identifier | 原始檔名。供案件追蹤與識別使用，醫院上傳時無須填寫。 | |
| use |
1..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: usual | |
| identifier:old_acpt_no |
0..1 | Identifier | 原受理編號。院所上傳送核(subType = #1)案件時，不需填寫「原受理編號」資訊，受理成功後會由系統自動產生受理編號。當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。 | |
| use |
1..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: secondary | |
| status |
1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Required Pattern: active | |
| type |
1..1 | CodeableConcept | Category or discipline Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: institutional | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| subType |
1..1 | CodeableConcept | 申報類別，1:送核 | 2:送核補件 | 3:申復 | 4:爭議審議 | 5:申復補件 。院所上傳送核(subType = #1)案件時，不需填寫「原受理編號」資訊，受理成功後會由系統自動產生受理編號。當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier填寫原送核案件之受理編號。 Binding: NHI-健保事前審查-申報類別值集 (required) | |
| coding |
1..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-apply-type | |
| code |
1..1 | code | 申報類別，1:送核 | 2:送核補件 | 3:申復 | 4:爭議審議 | 5:申復補件 。當申報類別為2(送核補件)、3(申復)、4(爭議審議)、5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。 | |
| use |
1..1 | code | claim | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim. Required Pattern: preauthorization | |
| patient |
1..1 | Reference(病人資訊-Patient TWPAS) | 病人資訊 | |
| created |
1..1 | dateTime | 申請日期，YYYY-MM-DD，機構自填。健保署收案後另建受理日期，將呈現在ClaimResponse的disposition和created欄位。 | |
| enterer |
1..1 | Reference(醫事人員-Practitioner TWPAS) | 申請醫師，必須存在於醫事人員基本資料檔內，並於合約生效起迄日內。 | |
| provider |
1..1 | Reference(醫事機構-Organization TWPAS) | 醫事機構代碼，必須存在於醫事機構基本資料檔內。 | |
| priority |
1..1 | CodeableConcept | 申請案件類別，1:一般事前審查申請 | 3:自主審查 | 4:緊急報備；專審系統識別用，對應PXXT_CODE(TMHB,001)。 Binding: NHI-健保事前審查-申請案件類別值集 (required) | |
| Slices for supportingInfo |
2..* | BackboneElement | Supporting information Slice: Unordered, Closed by value:category Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| supportingInfo:All Slices |
Content/Rules for all slices | |||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | 因FHIR設計而必填、自動流水號（建議每次加1）、不得重複，作為每筆supportingInfo的唯一識別碼。最後一筆sequence號碼即表示總筆數。 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: NHI-健保事前審查-補充資訊類別值集 (required) | |
| supportingInfo:weight |
C | 1..1 | BackboneElement | 病人體重 Constraints: HTWT |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: weight | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Quantity | Data to be provided | |
| value |
1..1 | decimal | 體重，整數至多3位數及小數至多2位數。 | |
| comparator |
0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented. | |
| system |
C | 1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org |
| code |
1..1 | code | Coded form of the unit Required Pattern: kg | |
| supportingInfo:height |
C | 1..1 | BackboneElement | 病人身高 Constraints: HTWT |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: height | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Quantity | Data to be provided | |
| value |
1..1 | decimal | 身高(cm)，整數至多3位數及小數至多2位數。 | |
| comparator |
0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented. | |
| system |
C | 1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org |
| code |
1..1 | code | Coded form of the unit Required Pattern: cm | |
| supportingInfo:pregnancy |
0..1 | BackboneElement | 是否懷孕或哺乳 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: pregnancyBreastfeedingStatus | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | boolean | 是否懷孕或哺乳，false:未懷孕或哺乳 | true:有懷孕或哺乳 | |
| supportingInfo:imagingReport |
0..* | BackboneElement | 影像報告 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: imagingReport | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(影像報告-DiagnosticReport Image TWPAS) | 影像報告 | |
| supportingInfo:cancerStage |
0..* | BackboneElement | 癌症分期量表 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: cancerStage | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(癌症分期量表-Observation Cancer Stage TWPAS) | 癌症分期量表 | |
| supportingInfo:examinationReport |
0..* | BackboneElement | 檢查報告 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: examinationReport | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(檢查報告-DiagnosticReport TWPAS) | 檢查報告 | |
| supportingInfo:geneInfo |
0..* | BackboneElement | 基因資訊 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: geneInfo | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(基因資訊-Observation Diagnostic TWPAS) | 基因資訊 | |
| supportingInfo:tests |
0..* | BackboneElement | 檢驗(查) | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: tests | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(檢驗檢查-Observation Laboratory Result TWPAS) | 檢驗(查) | |
| supportingInfo:patientAssessment |
0..* | BackboneElement | 病人狀態評估 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: patientAssessment | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(病人狀態評估-Observation Patient Assessment TWPAS) | 病人狀態評估 | |
| supportingInfo:medicationRequest |
0..* | BackboneElement | 用藥品項 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: medicationRequest | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(用藥品項-MedicationRequest Treat TWPAS) | 用藥品項 | |
| supportingInfo:radiotherapy |
0..* | BackboneElement | 放射治療 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: radiotherapy | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(放射治療-Procedure TWPAS) | 放射治療 | |
| supportingInfo:carePlanDocument |
0..* | BackboneElement | 治療計畫文件，P-IO(免疫檢查點抑制劑治療計畫)、P-CART(CAR-T多團隊會議紀錄)、P-STEMCELL(造血幹細胞移植計畫書)，附件形式PDF | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: carePlanDocument | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(文件參照-DocumentReference TWPAS) | 治療計畫文件 | |
| supportingInfo:medicalRecord |
0..* | BackboneElement | 病歷資料（非屬影像報告檢查驗報告部分），可檢附其他佐證癌藥治療必要性之非結構化病歷。 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: medicalRecord | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(文件參照-DocumentReference TWPAS) | Data to be provided | |
| supportingInfo:treatmentAssessment |
0..* | BackboneElement | 結果資訊 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: treatmentAssessment | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(治療後疾病狀態評估-Observation Treatment Assessment TWPAS) | 結果資訊 | |
| supportingInfo:bloodgroup |
0..1 | BackboneElement | 血型 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: bloodgroup | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(血型-Observation Blood Group TWPAS) | 血型 | |
| supportingInfo:opd |
0..* | BackboneElement | 門診病歷 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: opd | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(門診病歷-Composition OPD TWPAS) | 門診病歷 | |
| supportingInfo:allergy |
0..* | BackboneElement | 過敏史 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Information instance identifier | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: allergy | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value[x] |
1..1 | Reference(過敏史-AllergyIntolerance TWPAS) | 過敏史 | |
| diagnosis |
C | 1..* | BackboneElement | sequence=1時為主要疾病；sequence>=2代表共病。 Constraints: diagnosis |
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| extension:recordedDate |
0..* | date | 診斷日期，sequence=1時為必填，表示為用藥事前審查之主要疾病；其他共病不須填寫診斷日期。YYYY-MM-DD，西元年月日。【此為參考Da Vinci PAS IG的extension設計】 URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | sequence=1時為主要疾病；sequence>=2代表共病。 | |
| diagnosis[x] |
1..1 | CodeableConcept | 國際疾病分類代碼(含共病)，當前疾病狀態。ICD-10-CM。 Binding: 臺灣健保署2023年中文版ICD-10-CM值集 (preferred) | |
| Slices for coding |
0..* | Coding | Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:icd10-cm-2023 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2023年中文版ICD-10-CM值集 (extensible) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| coding:icd10-cm-2014 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2014年中文版ICD-10-CM值集 (extensible) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2014-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| type |
0..1 | CodeableConcept | Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. | |
| text |
C | 0..1 | string | 簡要病摘(申請理由)。連結院內HIS系統之簡要病摘，或填寫原事前審查之申請理由。請勿將醫事機構名稱、病人及醫師姓名等資訊列入結果中上傳，且不得包含HTML或XML等語法。 Constraints: pas-2 |
| procedure |
0..* | BackboneElement | Clinical procedures performed | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Procedure instance identifier | |
| date |
1..1 | dateTime | 手術(或其他處置)日期 | |
| procedure[x] |
1..1 | CodeableConcept | 手術(或其他處置)項目，經動脈導管肝臟腫瘤化學栓塞術(TACE)及冷凍療法等非屬手術。ICD-10-PCS 或 健保代碼 或 其他。 Binding: 臺灣健保署2023年中文版ICD-10-PCS值集 (preferred) | |
| Slices for coding |
1..1 | Coding | Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:icd10-pcs-2023 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2023年中文版ICD-10-PCS值集 (required) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2023-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| coding:icd10-pcs-2014 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2014年中文版ICD-10-PCS值集 (required) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2014-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| coding:medical-service-payment |
0..1 | Coding | Code defined by a terminology system Binding: NHI-健保事前審查-醫療服務給付項目值集 (required) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/medical-service-payment-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| insurance |
1..* | BackboneElement | Patient insurance information | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Insurance instance identifier Required Pattern: 1 | |
| focal |
1..1 | boolean | Coverage to be used for adjudication | |
| coverage |
1..1 | Reference(健保事前審查計畫-Coverage TWPAS) | Insurance information | |
| item |
1..* | BackboneElement | Product or service provided | |
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| extension:requestedService |
1..1 | Reference(事前審查品項-MedicationRequest Apply TWPAS) | 事前審查品項【此為參考Da Vinci PAS IG的extension設計】 URL: https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-requestedService | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| sequence |
1..1 | positiveInt | Item instance identifier | |
| productOrService |
1..1 | CodeableConcept | 醫令類別 Binding: NHI-健保事前審查-醫令類別值集 (required) | |
| Slices for modifier |
1..2 | CodeableConcept | Product or service billing modifiers Slice: Unordered, Closed by value:coding.system Binding: ModifierTypeCodes (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. Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| modifier:continuation |
1..1 | CodeableConcept | 續用註記，1:初次使用 | 2:申請再次使用 Binding: NHI-健保事前審查-續用註記值集 (required) | |
| coding |
1..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status | |
| code |
1..1 | code | 1:初次使用 | 2:申請再次使用 | |
| modifier:lot |
0..1 | CodeableConcept | 用藥線別，0:不適用 | 1:第一線治療 | 2:第二線治療 | 3:第三線治療 | 4:第四線治療 | 5:第五線治療 Binding: NHI-健保事前審查-用藥線別值集 (required) | |
| coding |
1..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy | |
| code |
1..1 | code | 0:不適用 | 1:第一線治療 | 2:第二線治療 | 3:第三線治療 | 4:第四線治療 | 5:第五線治療 | |
| programCode |
C | 1..1 | CodeableConcept | 給付適應症條件，藥品給付規定內所規範之適應症或條件，若有特定事前審查品項代碼應以代碼填報。 Binding: ExampleProgramReasonCodes (example): Program specific reason codes. Constraints: pas-1 |
| coding |
0..1 | Coding | 給付適應症條件，當事前審查品項代碼為KC009612B5、KC010892B5、KC011112DE、KC011162B5、KC011362B5、KC01013229、KC01013230、KC01025219、KC01050238、KC01085229、KC00958229、JC00154261、KC01088229、KC01233224時，才可填寫。 Binding: NHI-健保事前審查-給付適應症值集 (required) | |
| text |
0..1 | string | 給付適應症條件，事前審查品項代碼不為KC009612B5、KC010892B5、KC011112DE、KC011162B5、KC011362B5、KC01013229、KC01013230、KC01025219、KC01050238、KC01085229、KC00958229、JC00154261、KC01088229、KC01233224時，請自行輸入文字。 | |
| quantity |
C | 1..1 | SimpleQuantity(4.0.1) | Count of products or services Binding: NHI-健保事前審查-藥品劑量單位及包裝類型值集 (required): 事前審查申請數量單位及包裝類型。 Constraints: sqty-1 |
| value |
1..1 | decimal | 事前審查申請數量 | |
| system |
C | 1..1 | uri | 事前審查申請數量單位及包裝類型之代碼系統 |
| code |
1..1 | code | 事前審查申請數量單位及包裝類型 | |
| bodySite |
0..1 | CodeableConcept | 申請部位，R:右側 | L:左側 | B:兩側。(此專案暫不檢核，未來待確認) Binding: NHI-健保事前審查-申請部位值集 (required) | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Claim.identifier:orig_file_name.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std. |
| Claim.identifier:old_acpt_no.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std. |
| Claim.status | Base | required | Financial Resource Status Codes | 📍4.0.1 | FHIR Std. |
| Claim.type | Base | extensible | Claim Type Codes | 📍4.0.1 | FHIR Std. |
| Claim.subType | Base | required | NHI-健保事前審查-申報類別值集 | 📦1.2.8 | This IG |
| Claim.use | Base | required | Use | 📍4.0.1 | FHIR Std. |
| Claim.priority | Base | required | NHI-健保事前審查-申請案件類別值集 | 📦1.2.8 | This IG |
| Claim.supportingInfo.category | Base | required | NHI-健保事前審查-補充資訊類別值集 | 📦1.2.8 | This IG |
| Claim.supportingInfo:weight.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:weight.value[x].comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:height.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:height.value[x].comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:pregnancy.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:imagingReport.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:cancerStage.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:examinationReport.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:geneInfo.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:tests.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:patientAssessment.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicationRequest.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:radiotherapy.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:carePlanDocument.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicalRecord.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:treatmentAssessment.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:bloodgroup.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:opd.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:allergy.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.diagnosis.diagnosis[x] | Base | preferred | 臺灣健保署2023年中文版ICD-10-CM值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023 | Base | extensible | 臺灣健保署2023年中文版ICD-10-CM值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014 | Base | extensible | 臺灣健保署2014年中文版ICD-10-CM值集 | 📦2017-07-19 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.type | Base | example | Example Diagnosis Type Codes | 📍4.0.1 | FHIR Std. |
| Claim.procedure.procedure[x] | Base | preferred | 臺灣健保署2023年中文版ICD-10-PCS值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:icd10-pcs-2023 | Base | required | 臺灣健保署2023年中文版ICD-10-PCS值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:icd10-pcs-2014 | Base | required | 臺灣健保署2014年中文版ICD-10-PCS值集 | 📦2017-07-19 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:medical-service-payment | Base | required | NHI-健保事前審查-醫療服務給付項目值集 | 📦1.2.8 | This IG |
| Claim.item.productOrService | Base | required | NHI-健保事前審查-醫令類別值集 | 📦1.2.8 | This IG |
| Claim.item.modifier | Base | example | Modifier type Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.modifier:continuation | Base | required | NHI-健保事前審查-續用註記值集 | 📦1.2.8 | This IG |
| Claim.item.modifier:lot | Base | required | NHI-健保事前審查-用藥線別值集 | 📦1.2.8 | This IG |
| Claim.item.programCode | Base | example | Example Program Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.programCode.coding | Base | required | NHI-健保事前審查-給付適應症值集 | 📦1.2.8 | This IG |
| Claim.item.quantity | Base | required | NHI-健保事前審查-藥品劑量單位及包裝類型值集 | 📦1.2.8 | This IG |
| Claim.item.bodySite | Base | required | NHI-健保事前審查-申請部位值集 | 📦1.2.8 | This IG |
| Id | Grade | Path(s) | Description | Expression |
| HTWT | error | Claim.supportingInfo:weight, Claim.supportingInfo:height | 整數至多3位數及小數至多2位數 |
value.ofType(Quantity).value < 1000 and ((value.ofType(Quantity).value * 100).round() / 100) = value.ofType(Quantity).value
|
| applType | error | Claim | 當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。目前IG僅針對申報類別為3(申復)進行檢核。 |
(subType.coding.exists(code='3')) implies (identifier.where(use = 'secondary').exists())
|
| diagnosis | error | Claim.diagnosis | diagnosis.sequence=1時才需填寫診斷日期、簡要病摘(申請原因) |
sequence=1 implies (extension.where(url = 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate').value.ofType(date).exists() and type.text.exists() )
|
| dom-2 | error | Claim | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | Claim | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | Claim | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | Claim | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | Claim | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| pas-1 | error | Claim.item.programCode | text、coding至少需存在一個。 |
text.exists() or coding.exists()
|
| pas-2 | error | Claim.diagnosis.type.text | 長度不得超過4000 bytes。 |
toString().length() <= 4000
|
| sequence-1 | error | Claim | diagnosis.sequence一定會有一個「1」，且只能出現一次。 |
diagnosis.where(sequence = 1).count() = 1
|
| sqty-1 | error | Claim.item.quantity | The comparator is not used on a SimpleQuantity |
comparator.empty()
|
| supportingInfo | error | Claim | 當Claim.priority(案件類別)為1(一般事前審查申請)、3(自主審查)時，至少還需提供檢查報告、影像報告、基因資訊中任一樣資訊。如果Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C61，且Claim.item.modifier:continuation(續用註記)為2，則可排除此條件。或Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C90、C91或C92，則可排除此條件。 |
(priority.coding.code.matches('1|3')) implies (supportingInfo.category.exists(coding.code = 'examinationReport') or supportingInfo.category.exists(coding.code = 'imagingReport') or supportingInfo.category.exists(coding.code = 'geneInfo') or (diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C61)')).exists() and item.modifier.where(coding.system = 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status').coding.exists(code = '2')) or (diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C90|C91|C92)')).exists()))
|
| supportingInfo-c90-c91-c92 | error | Claim | 當Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C90、C91或C92，需提供檢驗(查)、影像報告、基因資訊、檢驗檢查中任一項資訊。 |
(diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C90|C91|C92)')).exists()) implies (supportingInfo.category.exists(coding.code = 'tests') or supportingInfo.category.exists(coding.code = 'imagingReport') or supportingInfo.category.exists(coding.code = 'geneInfo') or supportingInfo.category.exists(coding.code = 'examinationReport'))
|
| supportingInfo-tests | error | Claim | 當Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C61，且Claim.item.modifier:continuation(續用註記)為2，需提供檢驗(查)。 |
(diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C61)')).exists() and (item.modifier.where(coding.system = 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status').coding.exists(code = '2'))) implies (supportingInfo.category.exists(coding.code = 'tests'))
|
Differential View
This structure is derived from Claim
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Claim |
C | 0..* | Claim | Claim, Pre-determination or Pre-authorization Constraints: sequence-1, applType, supportingInfo, supportingInfo-tests, supportingInfo-c90-c91-c92 |
| id |
0..1 | id | 收件序號/案件編號，供案件追蹤與識別使用，醫院上傳時無須填寫。 | |
| meta |
1..1 | Meta | Metadata about the resource | |
| lastUpdated |
0..1 | instant | 上傳日期時間。供案件追蹤與識別使用，醫院上傳時無須填寫。 | |
| profile |
1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-twpas | |
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| extension:encounter |
1..1 | Reference(就醫科別-Encounter TWPAS) | 就醫科別，為細分科之就醫科別，作為審查分科用。【此為參考Da Vinci PAS IG的extension設計】 URL: https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-claim-encounter | |
| Slices for identifier |
0..* | Identifier | Business Identifier for claim Slice: Unordered, Open by value:use Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| identifier:orig_file_name |
0..1 | Identifier | 原始檔名。供案件追蹤與識別使用，醫院上傳時無須填寫。 | |
| use |
1..1 | code | usual | official | temp | secondary | old (If known) Required Pattern: usual | |
| identifier:old_acpt_no |
0..1 | Identifier | 原受理編號。院所上傳送核(subType = #1)案件時，不需填寫「原受理編號」資訊，受理成功後會由系統自動產生受理編號。當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。 | |
| use |
1..1 | code | usual | official | temp | secondary | old (If known) Required Pattern: secondary | |
| status |
1..1 | code | active | cancelled | draft | entered-in-error Required Pattern: active | |
| type |
1..1 | CodeableConcept | Category or discipline Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: institutional | |
| subType |
1..1 | CodeableConcept | 申報類別，1:送核 | 2:送核補件 | 3:申復 | 4:爭議審議 | 5:申復補件 。院所上傳送核(subType = #1)案件時，不需填寫「原受理編號」資訊，受理成功後會由系統自動產生受理編號。當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier填寫原送核案件之受理編號。 Binding: NHI-健保事前審查-申報類別值集 (required) | |
| coding |
1..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-apply-type | |
| code |
1..1 | code | 申報類別，1:送核 | 2:送核補件 | 3:申復 | 4:爭議審議 | 5:申復補件 。當申報類別為2(送核補件)、3(申復)、4(爭議審議)、5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。 | |
| use |
1..1 | code | claim | preauthorization | predetermination Required Pattern: preauthorization | |
| patient |
1..1 | Reference(病人資訊-Patient TWPAS) | 病人資訊 | |
| created |
1..1 | dateTime | 申請日期，YYYY-MM-DD，機構自填。健保署收案後另建受理日期，將呈現在ClaimResponse的disposition和created欄位。 | |
| enterer |
1..1 | Reference(醫事人員-Practitioner TWPAS) | 申請醫師，必須存在於醫事人員基本資料檔內，並於合約生效起迄日內。 | |
| provider |
1..1 | Reference(醫事機構-Organization TWPAS) | 醫事機構代碼，必須存在於醫事機構基本資料檔內。 | |
| priority |
1..1 | CodeableConcept | 申請案件類別，1:一般事前審查申請 | 3:自主審查 | 4:緊急報備；專審系統識別用，對應PXXT_CODE(TMHB,001)。 Binding: NHI-健保事前審查-申請案件類別值集 (required) | |
| Slices for supportingInfo |
2..* | BackboneElement | Supporting information Slice: Unordered, Closed by value:category Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| supportingInfo:All Slices |
Content/Rules for all slices | |||
| sequence |
1..1 | positiveInt | 因FHIR設計而必填、自動流水號（建議每次加1）、不得重複，作為每筆supportingInfo的唯一識別碼。最後一筆sequence號碼即表示總筆數。 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: NHI-健保事前審查-補充資訊類別值集 (required) | |
| supportingInfo:weight |
C | 1..1 | BackboneElement | 病人體重 Constraints: HTWT |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: weight | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Quantity | Data to be provided | |
| value |
1..1 | decimal | 體重，整數至多3位數及小數至多2位數。 | |
| system |
1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org | |
| code |
1..1 | code | Coded form of the unit Required Pattern: kg | |
| supportingInfo:height |
C | 1..1 | BackboneElement | 病人身高 Constraints: HTWT |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: height | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Quantity | Data to be provided | |
| value |
1..1 | decimal | 身高(cm)，整數至多3位數及小數至多2位數。 | |
| system |
1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org | |
| code |
1..1 | code | Coded form of the unit Required Pattern: cm | |
| supportingInfo:pregnancy |
0..1 | BackboneElement | 是否懷孕或哺乳 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: pregnancyBreastfeedingStatus | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | boolean | 是否懷孕或哺乳，false:未懷孕或哺乳 | true:有懷孕或哺乳 | |
| supportingInfo:imagingReport |
0..* | BackboneElement | 影像報告 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: imagingReport | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(影像報告-DiagnosticReport Image TWPAS) | 影像報告 | |
| supportingInfo:cancerStage |
0..* | BackboneElement | 癌症分期量表 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: cancerStage | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(癌症分期量表-Observation Cancer Stage TWPAS) | 癌症分期量表 | |
| supportingInfo:examinationReport |
0..* | BackboneElement | 檢查報告 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: examinationReport | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(檢查報告-DiagnosticReport TWPAS) | 檢查報告 | |
| supportingInfo:geneInfo |
0..* | BackboneElement | 基因資訊 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: geneInfo | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(基因資訊-Observation Diagnostic TWPAS) | 基因資訊 | |
| supportingInfo:tests |
0..* | BackboneElement | 檢驗(查) | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: tests | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(檢驗檢查-Observation Laboratory Result TWPAS) | 檢驗(查) | |
| supportingInfo:patientAssessment |
0..* | BackboneElement | 病人狀態評估 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: patientAssessment | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(病人狀態評估-Observation Patient Assessment TWPAS) | 病人狀態評估 | |
| supportingInfo:medicationRequest |
0..* | BackboneElement | 用藥品項 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: medicationRequest | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(用藥品項-MedicationRequest Treat TWPAS) | 用藥品項 | |
| supportingInfo:radiotherapy |
0..* | BackboneElement | 放射治療 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: radiotherapy | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(放射治療-Procedure TWPAS) | 放射治療 | |
| supportingInfo:carePlanDocument |
0..* | BackboneElement | 治療計畫文件，P-IO(免疫檢查點抑制劑治療計畫)、P-CART(CAR-T多團隊會議紀錄)、P-STEMCELL(造血幹細胞移植計畫書)，附件形式PDF | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: carePlanDocument | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(文件參照-DocumentReference TWPAS) | 治療計畫文件 | |
| supportingInfo:medicalRecord |
0..* | BackboneElement | 病歷資料（非屬影像報告檢查驗報告部分），可檢附其他佐證癌藥治療必要性之非結構化病歷。 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: medicalRecord | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(文件參照-DocumentReference TWPAS) | Data to be provided | |
| supportingInfo:treatmentAssessment |
0..* | BackboneElement | 結果資訊 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: treatmentAssessment | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(治療後疾病狀態評估-Observation Treatment Assessment TWPAS) | 結果資訊 | |
| supportingInfo:bloodgroup |
0..1 | BackboneElement | 血型 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: bloodgroup | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(血型-Observation Blood Group TWPAS) | 血型 | |
| supportingInfo:opd |
0..* | BackboneElement | 門診病歷 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: opd | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(門診病歷-Composition OPD TWPAS) | 門診病歷 | |
| supportingInfo:allergy |
0..* | BackboneElement | 過敏史 | |
| category |
1..1 | CodeableConcept | Classification of the supplied information Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: allergy | |
| timing[x] |
0..0 | When it occurred | ||
| value[x] |
1..1 | Reference(過敏史-AllergyIntolerance TWPAS) | 過敏史 | |
| diagnosis |
C | 1..* | BackboneElement | sequence=1時為主要疾病；sequence>=2代表共病。 Constraints: diagnosis |
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| extension:recordedDate |
0..* | date | 診斷日期，sequence=1時為必填，表示為用藥事前審查之主要疾病；其他共病不須填寫診斷日期。YYYY-MM-DD，西元年月日。【此為參考Da Vinci PAS IG的extension設計】 URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate | |
| sequence |
1..1 | positiveInt | sequence=1時為主要疾病；sequence>=2代表共病。 | |
| diagnosis[x] |
1..1 | CodeableConcept | 國際疾病分類代碼(含共病)，當前疾病狀態。ICD-10-CM。 Binding: 臺灣健保署2023年中文版ICD-10-CM值集 (preferred) | |
| Slices for coding |
0..* | Coding | Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:icd10-cm-2023 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2023年中文版ICD-10-CM值集 (extensible) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| coding:icd10-cm-2014 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2014年中文版ICD-10-CM值集 (extensible) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2014-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| type |
0..1 | CodeableConcept | Timing or nature of the diagnosis | |
| text |
C | 0..1 | string | 簡要病摘(申請理由)。連結院內HIS系統之簡要病摘，或填寫原事前審查之申請理由。請勿將醫事機構名稱、病人及醫師姓名等資訊列入結果中上傳，且不得包含HTML或XML等語法。 Constraints: pas-2 |
| procedure |
||||
| date |
1..1 | dateTime | 手術(或其他處置)日期 | |
| procedure[x] |
1..1 | CodeableConcept | 手術(或其他處置)項目，經動脈導管肝臟腫瘤化學栓塞術(TACE)及冷凍療法等非屬手術。ICD-10-PCS 或 健保代碼 或 其他。 Binding: 臺灣健保署2023年中文版ICD-10-PCS值集 (preferred) | |
| Slices for coding |
1..1 | Coding | Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:icd10-pcs-2023 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2023年中文版ICD-10-PCS值集 (required) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2023-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| coding:icd10-pcs-2014 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2014年中文版ICD-10-PCS值集 (required) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2014-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| coding:medical-service-payment |
0..1 | Coding | Code defined by a terminology system Binding: NHI-健保事前審查-醫療服務給付項目值集 (required) | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/medical-service-payment-tw | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| insurance |
||||
| sequence |
1..1 | positiveInt | Insurance instance identifier Required Pattern: 1 | |
| coverage |
1..1 | Reference(健保事前審查計畫-Coverage TWPAS) | Insurance information | |
| item |
1..* | BackboneElement | Product or service provided | |
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| extension:requestedService |
1..1 | Reference(事前審查品項-MedicationRequest Apply TWPAS) | 事前審查品項【此為參考Da Vinci PAS IG的extension設計】 URL: https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-requestedService | |
| productOrService |
1..1 | CodeableConcept | 醫令類別 Binding: NHI-健保事前審查-醫令類別值集 (required) | |
| Slices for modifier |
1..2 | CodeableConcept | Product or service billing modifiers Slice: Unordered, Closed by value:coding.system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| modifier:continuation |
1..1 | CodeableConcept | 續用註記，1:初次使用 | 2:申請再次使用 Binding: NHI-健保事前審查-續用註記值集 (required) | |
| coding |
1..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status | |
| code |
1..1 | code | 1:初次使用 | 2:申請再次使用 | |
| modifier:lot |
0..1 | CodeableConcept | 用藥線別，0:不適用 | 1:第一線治療 | 2:第二線治療 | 3:第三線治療 | 4:第四線治療 | 5:第五線治療 Binding: NHI-健保事前審查-用藥線別值集 (required) | |
| coding |
1..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy | |
| code |
1..1 | code | 0:不適用 | 1:第一線治療 | 2:第二線治療 | 3:第三線治療 | 4:第四線治療 | 5:第五線治療 | |
| programCode |
C | 1..1 | CodeableConcept | 給付適應症條件，藥品給付規定內所規範之適應症或條件，若有特定事前審查品項代碼應以代碼填報。 Constraints: pas-1 |
| coding |
0..1 | Coding | 給付適應症條件，當事前審查品項代碼為KC009612B5、KC010892B5、KC011112DE、KC011162B5、KC011362B5、KC01013229、KC01013230、KC01025219、KC01050238、KC01085229、KC00958229、JC00154261、KC01088229、KC01233224時，才可填寫。 Binding: NHI-健保事前審查-給付適應症值集 (required) | |
| text |
0..1 | string | 給付適應症條件，事前審查品項代碼不為KC009612B5、KC010892B5、KC011112DE、KC011162B5、KC011362B5、KC01013229、KC01013230、KC01025219、KC01050238、KC01085229、KC00958229、JC00154261、KC01088229、KC01233224時，請自行輸入文字。 | |
| quantity |
1..1 | SimpleQuantity(4.0.1) | Count of products or services Binding: NHI-健保事前審查-藥品劑量單位及包裝類型值集 (required): 事前審查申請數量單位及包裝類型。 | |
| value |
1..1 | decimal | 事前審查申請數量 | |
| system |
1..1 | uri | 事前審查申請數量單位及包裝類型之代碼系統 | |
| code |
1..1 | code | 事前審查申請數量單位及包裝類型 | |
| bodySite |
0..1 | CodeableConcept | 申請部位，R:右側 | L:左側 | B:兩側。(此專案暫不檢核，未來待確認) Binding: NHI-健保事前審查-申請部位值集 (required) | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Claim.subType | Base | required | NHI-健保事前審查-申報類別值集 | 📦1.2.8 | This IG |
| Claim.priority | Base | required | NHI-健保事前審查-申請案件類別值集 | 📦1.2.8 | This IG |
| Claim.supportingInfo.category | Base | required | NHI-健保事前審查-補充資訊類別值集 | 📦1.2.8 | This IG |
| Claim.diagnosis.diagnosis[x] | Base | preferred | 臺灣健保署2023年中文版ICD-10-CM值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023 | Base | extensible | 臺灣健保署2023年中文版ICD-10-CM值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014 | Base | extensible | 臺灣健保署2014年中文版ICD-10-CM值集 | 📦2017-07-19 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x] | Base | preferred | 臺灣健保署2023年中文版ICD-10-PCS值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:icd10-pcs-2023 | Base | required | 臺灣健保署2023年中文版ICD-10-PCS值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:icd10-pcs-2014 | Base | required | 臺灣健保署2014年中文版ICD-10-PCS值集 | 📦2017-07-19 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:medical-service-payment | Base | required | NHI-健保事前審查-醫療服務給付項目值集 | 📦1.2.8 | This IG |
| Claim.item.productOrService | Base | required | NHI-健保事前審查-醫令類別值集 | 📦1.2.8 | This IG |
| Claim.item.modifier:continuation | Base | required | NHI-健保事前審查-續用註記值集 | 📦1.2.8 | This IG |
| Claim.item.modifier:lot | Base | required | NHI-健保事前審查-用藥線別值集 | 📦1.2.8 | This IG |
| Claim.item.programCode.coding | Base | required | NHI-健保事前審查-給付適應症值集 | 📦1.2.8 | This IG |
| Claim.item.quantity | Base | required | NHI-健保事前審查-藥品劑量單位及包裝類型值集 | 📦1.2.8 | This IG |
| Claim.item.bodySite | Base | required | NHI-健保事前審查-申請部位值集 | 📦1.2.8 | This IG |
| Id | Grade | Path(s) | Description | Expression |
| HTWT | error | Claim.supportingInfo:weight, Claim.supportingInfo:height | 整數至多3位數及小數至多2位數 |
value.ofType(Quantity).value < 1000 and ((value.ofType(Quantity).value * 100).round() / 100) = value.ofType(Quantity).value
|
| applType | error | Claim | 當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。目前IG僅針對申報類別為3(申復)進行檢核。 |
(subType.coding.exists(code='3')) implies (identifier.where(use = 'secondary').exists())
|
| diagnosis | error | Claim.diagnosis | diagnosis.sequence=1時才需填寫診斷日期、簡要病摘(申請原因) |
sequence=1 implies (extension.where(url = 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate').value.ofType(date).exists() and type.text.exists() )
|
| pas-1 | error | Claim.item.programCode | text、coding至少需存在一個。 |
text.exists() or coding.exists()
|
| pas-2 | error | Claim.diagnosis.type.text | 長度不得超過4000 bytes。 |
toString().length() <= 4000
|
| sequence-1 | error | Claim | diagnosis.sequence一定會有一個「1」，且只能出現一次。 |
diagnosis.where(sequence = 1).count() = 1
|
| supportingInfo | error | Claim | 當Claim.priority(案件類別)為1(一般事前審查申請)、3(自主審查)時，至少還需提供檢查報告、影像報告、基因資訊中任一樣資訊。如果Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C61，且Claim.item.modifier:continuation(續用註記)為2，則可排除此條件。或Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C90、C91或C92，則可排除此條件。 |
(priority.coding.code.matches('1|3')) implies (supportingInfo.category.exists(coding.code = 'examinationReport') or supportingInfo.category.exists(coding.code = 'imagingReport') or supportingInfo.category.exists(coding.code = 'geneInfo') or (diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C61)')).exists() and item.modifier.where(coding.system = 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status').coding.exists(code = '2')) or (diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C90|C91|C92)')).exists()))
|
| supportingInfo-c90-c91-c92 | error | Claim | 當Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C90、C91或C92，需提供檢驗(查)、影像報告、基因資訊、檢驗檢查中任一項資訊。 |
(diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C90|C91|C92)')).exists()) implies (supportingInfo.category.exists(coding.code = 'tests') or supportingInfo.category.exists(coding.code = 'imagingReport') or supportingInfo.category.exists(coding.code = 'geneInfo') or supportingInfo.category.exists(coding.code = 'examinationReport'))
|
| supportingInfo-tests | error | Claim | 當Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C61，且Claim.item.modifier:continuation(續用註記)為2，需提供檢驗(查)。 |
(diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C61)')).exists() and (item.modifier.where(coding.system = 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status').coding.exists(code = '2'))) implies (supportingInfo.category.exists(coding.code = 'tests'))
|
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| Claim |
C | 0..* | Claim | Claim, Pre-determination or Pre-authorization Constraints: sequence-1, applType, supportingInfo, supportingInfo-tests, supportingInfo-c90-c91-c92 | ||||
| id |
0..1 | id | 收件序號/案件編號，供案件追蹤與識別使用，醫院上傳時無須填寫。 | |||||
| meta |
1..1 | Meta | Metadata about the resource | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| versionId |
0..1 | id | Version specific identifier | |||||
| lastUpdated |
0..1 | instant | 上傳日期時間。供案件追蹤與識別使用，醫院上傳時無須填寫。 | |||||
| source |
0..1 | uri | Identifies where the resource comes from | |||||
| profile |
1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-twpas | |||||
| security |
0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | |||||
| tag |
0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | |||||
| implicitRules |
0..1 | uri | A set of rules under which this content was created | |||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| extension:encounter |
1..1 | Reference(就醫科別-Encounter TWPAS) | 就醫科別，為細分科之就醫科別，作為審查分科用。【此為參考Da Vinci PAS IG的extension設計】 URL: https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-claim-encounter | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |||||
| Slices for identifier |
0..* | Identifier | Business Identifier for claim Slice: Unordered, Open by value:use Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| identifier:orig_file_name |
0..1 | Identifier | 原始檔名。供案件追蹤與識別使用，醫院上傳時無須填寫。 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use |
1..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: usual | |||||
| type |
0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | |||||
| system |
0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | |||||
| value |
0..1 | string | The value that is unique Example General: 123456 | |||||
| period |
0..1 | Period | Time period when id is/was valid for use | |||||
| assigner |
0..1 | Reference(Organization) | Organization that issued id (may be just text) | |||||
| identifier:old_acpt_no |
0..1 | Identifier | 原受理編號。院所上傳送核(subType = #1)案件時，不需填寫「原受理編號」資訊，受理成功後會由系統自動產生受理編號。當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use |
1..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: secondary | |||||
| type |
0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | |||||
| system |
0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | |||||
| value |
0..1 | string | The value that is unique Example General: 123456 | |||||
| period |
0..1 | Period | Time period when id is/was valid for use | |||||
| assigner |
0..1 | Reference(Organization) | Organization that issued id (may be just text) | |||||
| status |
1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Required Pattern: active | |||||
| type |
1..1 | CodeableConcept | Category or discipline Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: institutional | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| subType |
1..1 | CodeableConcept | 申報類別，1:送核 | 2:送核補件 | 3:申復 | 4:爭議審議 | 5:申復補件 。院所上傳送核(subType = #1)案件時，不需填寫「原受理編號」資訊，受理成功後會由系統自動產生受理編號。當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier填寫原送核案件之受理編號。 Binding: NHI-健保事前審查-申報類別值集 (required) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
1..1 | Coding | Code defined by a terminology system | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-apply-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | 申報類別，1:送核 | 2:送核補件 | 3:申復 | 4:爭議審議 | 5:申復補件 。當申報類別為2(送核補件)、3(申復)、4(爭議審議)、5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。 | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| use |
1..1 | code | claim | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim. Required Pattern: preauthorization | |||||
| patient |
1..1 | Reference(病人資訊-Patient TWPAS) | 病人資訊 | |||||
| billablePeriod |
0..1 | Period | Relevant time frame for the claim | |||||
| created |
1..1 | dateTime | 申請日期，YYYY-MM-DD，機構自填。健保署收案後另建受理日期，將呈現在ClaimResponse的disposition和created欄位。 | |||||
| enterer |
1..1 | Reference(醫事人員-Practitioner TWPAS) | 申請醫師，必須存在於醫事人員基本資料檔內，並於合約生效起迄日內。 | |||||
| insurer |
0..1 | Reference(Organization) | Target | |||||
| provider |
1..1 | Reference(醫事機構-Organization TWPAS) | 醫事機構代碼，必須存在於醫事機構基本資料檔內。 | |||||
| priority |
1..1 | CodeableConcept | 申請案件類別，1:一般事前審查申請 | 3:自主審查 | 4:緊急報備；專審系統識別用，對應PXXT_CODE(TMHB,001)。 Binding: NHI-健保事前審查-申請案件類別值集 (required) | |||||
| fundsReserve |
0..1 | CodeableConcept | For whom to reserve funds Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None). | |||||
| related |
0..* | BackboneElement | Prior or corollary claims | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| claim |
0..1 | Reference(Claim) | Reference to the related claim | |||||
| relationship |
0..1 | CodeableConcept | How the reference claim is related Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim. | |||||
| reference |
0..1 | Identifier | File or case reference | |||||
| prescription |
0..1 | Reference(DeviceRequest | MedicationRequest | VisionPrescription) | Prescription authorizing services and products | |||||
| originalPrescription |
0..1 | Reference(DeviceRequest | MedicationRequest | VisionPrescription) | Original prescription if superseded by fulfiller | |||||
| payee |
0..1 | BackboneElement | Recipient of benefits payable | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| type |
1..1 | CodeableConcept | Category of recipient Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed. | |||||
| party |
0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson) | Recipient reference | |||||
| referral |
0..1 | Reference(ServiceRequest) | Treatment referral | |||||
| facility |
0..1 | Reference(Location) | Servicing facility | |||||
| careTeam |
0..* | BackboneElement | Members of the care team | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Order of care team | |||||
| provider |
1..1 | Reference(Practitioner | PractitionerRole | Organization) | Practitioner or organization | |||||
| responsible |
0..1 | boolean | Indicator of the lead practitioner | |||||
| role |
0..1 | CodeableConcept | Function within the team Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members. | |||||
| qualification |
0..1 | CodeableConcept | Practitioner credential or specialization Binding: ExampleProviderQualificationCodes (example): Provider professional qualifications. | |||||
| Slices for supportingInfo |
2..* | BackboneElement | Supporting information Slice: Unordered, Closed by value:category Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| supportingInfo:All Slices |
Content/Rules for all slices | |||||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | 因FHIR設計而必填、自動流水號（建議每次加1）、不得重複，作為每筆supportingInfo的唯一識別碼。最後一筆sequence號碼即表示總筆數。 | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: NHI-健保事前審查-補充資訊類別值集 (required) | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| timing[x] |
0..1 | When it occurred | ||||||
| timingDate |
date | |||||||
| timingPeriod |
Period | |||||||
| value[x] |
0..1 | Data to be provided | ||||||
| valueBoolean |
boolean | |||||||
| valueString |
string | |||||||
| valueQuantity |
Quantity | |||||||
| valueAttachment |
Attachment | |||||||
| valueReference |
Reference(Resource) | |||||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:weight |
C | 1..1 | BackboneElement | 病人體重 Constraints: HTWT | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: weight | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Quantity | Data to be provided | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| value |
1..1 | decimal | 體重，整數至多3位數及小數至多2位數。 | |||||
| comparator |
0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented. | |||||
| unit |
0..1 | string | Unit representation | |||||
| system |
C | 1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org | ||||
| code |
1..1 | code | Coded form of the unit Required Pattern: kg | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:height |
C | 1..1 | BackboneElement | 病人身高 Constraints: HTWT | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: height | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Quantity | Data to be provided | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| value |
1..1 | decimal | 身高(cm)，整數至多3位數及小數至多2位數。 | |||||
| comparator |
0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented. | |||||
| unit |
0..1 | string | Unit representation | |||||
| system |
C | 1..1 | uri | System that defines coded unit form Required Pattern: http://unitsofmeasure.org | ||||
| code |
1..1 | code | Coded form of the unit Required Pattern: cm | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:pregnancy |
0..1 | BackboneElement | 是否懷孕或哺乳 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: pregnancyBreastfeedingStatus | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | boolean | 是否懷孕或哺乳，false:未懷孕或哺乳 | true:有懷孕或哺乳 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:imagingReport |
0..* | BackboneElement | 影像報告 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: imagingReport | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(影像報告-DiagnosticReport Image TWPAS) | 影像報告 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:cancerStage |
0..* | BackboneElement | 癌症分期量表 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: cancerStage | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(癌症分期量表-Observation Cancer Stage TWPAS) | 癌症分期量表 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:examinationReport |
0..* | BackboneElement | 檢查報告 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: examinationReport | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(檢查報告-DiagnosticReport TWPAS) | 檢查報告 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:geneInfo |
0..* | BackboneElement | 基因資訊 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: geneInfo | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(基因資訊-Observation Diagnostic TWPAS) | 基因資訊 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:tests |
0..* | BackboneElement | 檢驗(查) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: tests | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(檢驗檢查-Observation Laboratory Result TWPAS) | 檢驗(查) | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:patientAssessment |
0..* | BackboneElement | 病人狀態評估 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: patientAssessment | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(病人狀態評估-Observation Patient Assessment TWPAS) | 病人狀態評估 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:medicationRequest |
0..* | BackboneElement | 用藥品項 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: medicationRequest | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(用藥品項-MedicationRequest Treat TWPAS) | 用藥品項 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:radiotherapy |
0..* | BackboneElement | 放射治療 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: radiotherapy | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(放射治療-Procedure TWPAS) | 放射治療 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:carePlanDocument |
0..* | BackboneElement | 治療計畫文件，P-IO(免疫檢查點抑制劑治療計畫)、P-CART(CAR-T多團隊會議紀錄)、P-STEMCELL(造血幹細胞移植計畫書)，附件形式PDF | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: carePlanDocument | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(文件參照-DocumentReference TWPAS) | 治療計畫文件 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:medicalRecord |
0..* | BackboneElement | 病歷資料（非屬影像報告檢查驗報告部分），可檢附其他佐證癌藥治療必要性之非結構化病歷。 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: medicalRecord | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(文件參照-DocumentReference TWPAS) | Data to be provided | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:treatmentAssessment |
0..* | BackboneElement | 結果資訊 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: treatmentAssessment | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(治療後疾病狀態評估-Observation Treatment Assessment TWPAS) | 結果資訊 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:bloodgroup |
0..1 | BackboneElement | 血型 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: bloodgroup | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(血型-Observation Blood Group TWPAS) | 血型 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:opd |
0..* | BackboneElement | 門診病歷 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: opd | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(門診病歷-Composition OPD TWPAS) | 門診病歷 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| supportingInfo:allergy |
0..* | BackboneElement | 過敏史 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Information instance identifier | |||||
| category |
1..1 | CodeableConcept | Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes. Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: allergy | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
0..1 | CodeableConcept | Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes. | |||||
| value[x] |
1..1 | Reference(過敏史-AllergyIntolerance TWPAS) | 過敏史 | |||||
| reason |
0..1 | CodeableConcept | Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth. | |||||
| diagnosis |
C | 1..* | BackboneElement | sequence=1時為主要疾病；sequence>=2代表共病。 Constraints: diagnosis | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| extension:recordedDate |
0..* | date | 診斷日期，sequence=1時為必填，表示為用藥事前審查之主要疾病；其他共病不須填寫診斷日期。YYYY-MM-DD，西元年月日。【此為參考Da Vinci PAS IG的extension設計】 URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | sequence=1時為主要疾病；sequence>=2代表共病。 | |||||
| diagnosis[x] |
1..1 | CodeableConcept | 國際疾病分類代碼(含共病)，當前疾病狀態。ICD-10-CM。 Binding: 臺灣健保署2023年中文版ICD-10-CM值集 (preferred) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| Slices for coding |
0..* | Coding | Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| coding:icd10-cm-2023 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2023年中文版ICD-10-CM值集 (extensible) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| coding:icd10-cm-2014 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2014年中文版ICD-10-CM值集 (extensible) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2014-tw | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| type |
0..1 | CodeableConcept | Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
0..* | Coding | Code defined by a terminology system | |||||
| text |
C | 0..1 | string | 簡要病摘(申請理由)。連結院內HIS系統之簡要病摘，或填寫原事前審查之申請理由。請勿將醫事機構名稱、病人及醫師姓名等資訊列入結果中上傳，且不得包含HTML或XML等語法。 Constraints: pas-2 | ||||
| onAdmission |
0..1 | CodeableConcept | Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission. | |||||
| packageCode |
0..1 | CodeableConcept | Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis. | |||||
| procedure |
0..* | BackboneElement | Clinical procedures performed | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Procedure instance identifier | |||||
| type |
0..* | CodeableConcept | Category of Procedure Binding: ExampleProcedureTypeCodes (example): Example procedure type codes. | |||||
| date |
1..1 | dateTime | 手術(或其他處置)日期 | |||||
| procedure[x] |
1..1 | CodeableConcept | 手術(或其他處置)項目，經動脈導管肝臟腫瘤化學栓塞術(TACE)及冷凍療法等非屬手術。ICD-10-PCS 或 健保代碼 或 其他。 Binding: 臺灣健保署2023年中文版ICD-10-PCS值集 (preferred) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| Slices for coding |
1..1 | Coding | Code defined by a terminology system Slice: Unordered, Closed by value:system Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| coding:icd10-pcs-2023 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2023年中文版ICD-10-PCS值集 (required) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2023-tw | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| coding:icd10-pcs-2014 |
0..1 | Coding | Code defined by a terminology system Binding: 臺灣健保署2014年中文版ICD-10-PCS值集 (required) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2014-tw | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| coding:medical-service-payment |
0..1 | Coding | Code defined by a terminology system Binding: NHI-健保事前審查-醫療服務給付項目值集 (required) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/medical-service-payment-tw | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| udi |
0..* | Reference(Device) | Unique device identifier | |||||
| insurance |
1..* | BackboneElement | Patient insurance information | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Insurance instance identifier Required Pattern: 1 | |||||
| focal |
1..1 | boolean | Coverage to be used for adjudication | |||||
| identifier |
0..1 | Identifier | Pre-assigned Claim number | |||||
| coverage |
1..1 | Reference(健保事前審查計畫-Coverage TWPAS) | Insurance information | |||||
| businessArrangement |
0..1 | string | Additional provider contract number | |||||
| preAuthRef |
0..* | string | Prior authorization reference number | |||||
| claimResponse |
0..1 | Reference(ClaimResponse) | Adjudication results | |||||
| accident |
0..1 | BackboneElement | Details of the event | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| date |
1..1 | date | When the incident occurred | |||||
| type |
0..1 | CodeableConcept | The nature of the accident Binding: ActIncidentCode (extensible): Type of accident: work place, auto, etc. | |||||
| location[x] |
0..1 | Where the event occurred | ||||||
| locationAddress |
Address | |||||||
| locationReference |
Reference(Location) | |||||||
| item |
1..* | BackboneElement | Product or service provided | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| extension:requestedService |
1..1 | Reference(事前審查品項-MedicationRequest Apply TWPAS) | 事前審查品項【此為參考Da Vinci PAS IG的extension設計】 URL: https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-requestedService | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Item instance identifier | |||||
| careTeamSequence |
0..* | positiveInt | Applicable careTeam members | |||||
| diagnosisSequence |
0..* | positiveInt | Applicable diagnoses | |||||
| procedureSequence |
0..* | positiveInt | Applicable procedures | |||||
| informationSequence |
0..* | positiveInt | Applicable exception and supporting information | |||||
| revenue |
0..1 | CodeableConcept | Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products. | |||||
| category |
0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses. | |||||
| productOrService |
1..1 | CodeableConcept | 醫令類別 Binding: NHI-健保事前審查-醫令類別值集 (required) | |||||
| Slices for modifier |
1..2 | CodeableConcept | Product or service billing modifiers Slice: Unordered, Closed by value:coding.system Binding: ModifierTypeCodes (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. Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| modifier:continuation |
1..1 | CodeableConcept | 續用註記，1:初次使用 | 2:申請再次使用 Binding: NHI-健保事前審查-續用註記值集 (required) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
1..1 | Coding | Code defined by a terminology system | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | 1:初次使用 | 2:申請再次使用 | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| modifier:lot |
0..1 | CodeableConcept | 用藥線別，0:不適用 | 1:第一線治療 | 2:第二線治療 | 3:第三線治療 | 4:第四線治療 | 5:第五線治療 Binding: NHI-健保事前審查-用藥線別值集 (required) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
1..1 | Coding | Code defined by a terminology system | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | 0:不適用 | 1:第一線治療 | 2:第二線治療 | 3:第三線治療 | 4:第四線治療 | 5:第五線治療 | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| programCode |
C | 1..1 | CodeableConcept | 給付適應症條件，藥品給付規定內所規範之適應症或條件，若有特定事前審查品項代碼應以代碼填報。 Binding: ExampleProgramReasonCodes (example): Program specific reason codes. Constraints: pas-1 | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
0..1 | Coding | 給付適應症條件，當事前審查品項代碼為KC009612B5、KC010892B5、KC011112DE、KC011162B5、KC011362B5、KC01013229、KC01013230、KC01025219、KC01050238、KC01085229、KC00958229、JC00154261、KC01088229、KC01233224時，才可填寫。 Binding: NHI-健保事前審查-給付適應症值集 (required) | |||||
| text |
0..1 | string | 給付適應症條件，事前審查品項代碼不為KC009612B5、KC010892B5、KC011112DE、KC011162B5、KC011362B5、KC01013229、KC01013230、KC01025219、KC01050238、KC01085229、KC00958229、JC00154261、KC01088229、KC01233224時，請自行輸入文字。 | |||||
| serviced[x] |
0..1 | Date or dates of service or product delivery | ||||||
| servicedDate |
date | |||||||
| servicedPeriod |
Period | |||||||
| location[x] |
0..1 | Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc. | ||||||
| locationCodeableConcept |
CodeableConcept | |||||||
| locationAddress |
Address | |||||||
| locationReference |
Reference(Location) | |||||||
| quantity |
C | 1..1 | SimpleQuantity(4.0.1) | Count of products or services Binding: NHI-健保事前審查-藥品劑量單位及包裝類型值集 (required): 事前審查申請數量單位及包裝類型。 Constraints: sqty-1 | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| value |
1..1 | decimal | 事前審查申請數量 | |||||
| unit |
0..1 | string | Unit representation | |||||
| system |
C | 1..1 | uri | 事前審查申請數量單位及包裝類型之代碼系統 | ||||
| code |
1..1 | code | 事前審查申請數量單位及包裝類型 | |||||
| unitPrice |
0..1 | Money | Fee, charge or cost per item | |||||
| factor |
0..1 | decimal | Price scaling factor | |||||
| net |
0..1 | Money | Total item cost | |||||
| udi |
0..* | Reference(Device) | Unique device identifier | |||||
| bodySite |
0..1 | CodeableConcept | 申請部位，R:右側 | L:左側 | B:兩側。(此專案暫不檢核，未來待確認) Binding: NHI-健保事前審查-申請部位值集 (required) | |||||
| subSite |
0..* | CodeableConcept | Anatomical sub-location Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations. | |||||
| encounter |
0..* | Reference(Encounter) | Encounters related to this billed item | |||||
| detail |
0..* | BackboneElement | Product or service provided | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Item instance identifier | |||||
| revenue |
0..1 | CodeableConcept | Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products. | |||||
| category |
0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses. | |||||
| productOrService |
1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |||||
| modifier |
0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (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..* | CodeableConcept | Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes. | |||||
| quantity |
C | 0..1 | SimpleQuantity(4.0.1) | Count of products or services Constraints: sqty-1 | ||||
| unitPrice |
0..1 | Money | Fee, charge or cost per item | |||||
| factor |
0..1 | decimal | Price scaling factor | |||||
| net |
0..1 | Money | Total item cost | |||||
| udi |
0..* | Reference(Device) | Unique device identifier | |||||
| subDetail |
0..* | BackboneElement | Product or service provided | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| sequence |
1..1 | positiveInt | Item instance identifier | |||||
| revenue |
0..1 | CodeableConcept | Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products. | |||||
| category |
0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses. | |||||
| productOrService |
1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |||||
| modifier |
0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (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..* | CodeableConcept | Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes. | |||||
| quantity |
C | 0..1 | SimpleQuantity(4.0.1) | Count of products or services Constraints: sqty-1 | ||||
| unitPrice |
0..1 | Money | Fee, charge or cost per item | |||||
| factor |
0..1 | decimal | Price scaling factor | |||||
| net |
0..1 | Money | Total item cost | |||||
| udi |
0..* | Reference(Device) | Unique device identifier | |||||
| total |
0..1 | Money | Total claim cost | |||||
| Documentation for this format | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| Claim.meta.security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std. |
| Claim.meta.tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std. |
| Claim.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| Claim.identifier:orig_file_name.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std. |
| Claim.identifier:orig_file_name.type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std. |
| Claim.identifier:old_acpt_no.use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std. |
| Claim.identifier:old_acpt_no.type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std. |
| Claim.status | Base | required | Financial Resource Status Codes | 📍4.0.1 | FHIR Std. |
| Claim.type | Base | extensible | Claim Type Codes | 📍4.0.1 | FHIR Std. |
| Claim.subType | Base | required | NHI-健保事前審查-申報類別值集 | 📦1.2.8 | This IG |
| Claim.use | Base | required | Use | 📍4.0.1 | FHIR Std. |
| Claim.priority | Base | required | NHI-健保事前審查-申請案件類別值集 | 📦1.2.8 | This IG |
| Claim.fundsReserve | Base | example | FundsReserve | 📍4.0.1 | FHIR Std. |
| Claim.related.relationship | Base | example | Example Related Claim Relationship Codes | 📍4.0.1 | FHIR Std. |
| Claim.payee.type | Base | example | PayeeType | 📍4.0.1 | FHIR Std. |
| Claim.careTeam.role | Base | example | Claim Care Team Role Codes | 📍4.0.1 | FHIR Std. |
| Claim.careTeam.qualification | Base | example | Example Provider Qualification Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo.category | Base | required | NHI-健保事前審查-補充資訊類別值集 | 📦1.2.8 | This IG |
| Claim.supportingInfo.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:weight.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:weight.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:weight.value[x].comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:weight.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:height.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:height.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:height.value[x].comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:height.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:pregnancy.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:pregnancy.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:pregnancy.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:imagingReport.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:imagingReport.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:imagingReport.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:cancerStage.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:cancerStage.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:cancerStage.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:examinationReport.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:examinationReport.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:examinationReport.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:geneInfo.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:geneInfo.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:geneInfo.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:tests.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:tests.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:tests.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:patientAssessment.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:patientAssessment.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:patientAssessment.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicationRequest.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicationRequest.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicationRequest.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:radiotherapy.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:radiotherapy.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:radiotherapy.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:carePlanDocument.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:carePlanDocument.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:carePlanDocument.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicalRecord.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicalRecord.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:medicalRecord.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:treatmentAssessment.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:treatmentAssessment.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:treatmentAssessment.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:bloodgroup.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:bloodgroup.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:bloodgroup.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:opd.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:opd.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:opd.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:allergy.category | Base | example | Claim Information Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:allergy.code | Base | example | Exception Codes | 📍4.0.1 | FHIR Std. |
| Claim.supportingInfo:allergy.reason | Base | example | Missing Tooth Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.diagnosis.diagnosis[x] | Base | preferred | 臺灣健保署2023年中文版ICD-10-CM值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023 | Base | extensible | 臺灣健保署2023年中文版ICD-10-CM值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014 | Base | extensible | 臺灣健保署2014年中文版ICD-10-CM值集 | 📦2017-07-19 | 臺灣核心實作指引 v0.3 |
| Claim.diagnosis.type | Base | example | Example Diagnosis Type Codes | 📍4.0.1 | FHIR Std. |
| Claim.diagnosis.onAdmission | Base | example | Example Diagnosis on Admission Codes | 📍4.0.1 | FHIR Std. |
| Claim.diagnosis.packageCode | Base | example | Example Diagnosis Related Group Codes | 📍4.0.1 | FHIR Std. |
| Claim.procedure.type | Base | example | Example Procedure Type Codes | 📍4.0.1 | FHIR Std. |
| Claim.procedure.procedure[x] | Base | preferred | 臺灣健保署2023年中文版ICD-10-PCS值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:icd10-pcs-2023 | Base | required | 臺灣健保署2023年中文版ICD-10-PCS值集 | 📦2024-11-18 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:icd10-pcs-2014 | Base | required | 臺灣健保署2014年中文版ICD-10-PCS值集 | 📦2017-07-19 | 臺灣核心實作指引 v0.3 |
| Claim.procedure.procedure[x].coding:medical-service-payment | Base | required | NHI-健保事前審查-醫療服務給付項目值集 | 📦1.2.8 | This IG |
| Claim.accident.type | Base | extensible | ActIncidentCode | 📦3.0.0 | THO v7.4 |
| Claim.item.revenue | Base | example | Example Revenue Center Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.category | Base | example | Benefit Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.productOrService | Base | required | NHI-健保事前審查-醫令類別值集 | 📦1.2.8 | This IG |
| Claim.item.modifier | Base | example | Modifier type Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.modifier:continuation | Base | required | NHI-健保事前審查-續用註記值集 | 📦1.2.8 | This IG |
| Claim.item.modifier:lot | Base | required | NHI-健保事前審查-用藥線別值集 | 📦1.2.8 | This IG |
| Claim.item.programCode | Base | example | Example Program Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.programCode.coding | Base | required | NHI-健保事前審查-給付適應症值集 | 📦1.2.8 | This IG |
| Claim.item.location[x] | Base | example | Example Service Place Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.quantity | Base | required | NHI-健保事前審查-藥品劑量單位及包裝類型值集 | 📦1.2.8 | This IG |
| Claim.item.bodySite | Base | required | NHI-健保事前審查-申請部位值集 | 📦1.2.8 | This IG |
| Claim.item.subSite | Base | example | Surface Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.revenue | Base | example | Example Revenue Center Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.category | Base | example | Benefit Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.productOrService | Base | example | USCLS Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.modifier | Base | example | Modifier type Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.programCode | Base | example | Example Program Reason Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.subDetail.revenue | Base | example | Example Revenue Center Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.subDetail.category | Base | example | Benefit Category Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.subDetail.productOrService | Base | example | USCLS Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.subDetail.modifier | Base | example | Modifier type Codes | 📍4.0.1 | FHIR Std. |
| Claim.item.detail.subDetail.programCode | Base | example | Example Program Reason Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| HTWT | error | Claim.supportingInfo:weight, Claim.supportingInfo:height | 整數至多3位數及小數至多2位數 |
value.ofType(Quantity).value < 1000 and ((value.ofType(Quantity).value * 100).round() / 100) = value.ofType(Quantity).value
|
| applType | error | Claim | 當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。目前IG僅針對申報類別為3(申復)進行檢核。 |
(subType.coding.exists(code='3')) implies (identifier.where(use = 'secondary').exists())
|
| diagnosis | error | Claim.diagnosis | diagnosis.sequence=1時才需填寫診斷日期、簡要病摘(申請原因) |
sequence=1 implies (extension.where(url = 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate').value.ofType(date).exists() and type.text.exists() )
|
| dom-2 | error | Claim | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | Claim | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | Claim | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | Claim | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | Claim | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| pas-1 | error | Claim.item.programCode | text、coding至少需存在一個。 |
text.exists() or coding.exists()
|
| pas-2 | error | Claim.diagnosis.type.text | 長度不得超過4000 bytes。 |
toString().length() <= 4000
|
| sequence-1 | error | Claim | diagnosis.sequence一定會有一個「1」，且只能出現一次。 |
diagnosis.where(sequence = 1).count() = 1
|
| sqty-1 | error | Claim.item.quantity, Claim.item.detail.quantity, Claim.item.detail.subDetail.quantity | The comparator is not used on a SimpleQuantity |
comparator.empty()
|
| supportingInfo | error | Claim | 當Claim.priority(案件類別)為1(一般事前審查申請)、3(自主審查)時，至少還需提供檢查報告、影像報告、基因資訊中任一樣資訊。如果Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C61，且Claim.item.modifier:continuation(續用註記)為2，則可排除此條件。或Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C90、C91或C92，則可排除此條件。 |
(priority.coding.code.matches('1|3')) implies (supportingInfo.category.exists(coding.code = 'examinationReport') or supportingInfo.category.exists(coding.code = 'imagingReport') or supportingInfo.category.exists(coding.code = 'geneInfo') or (diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C61)')).exists() and item.modifier.where(coding.system = 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status').coding.exists(code = '2')) or (diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C90|C91|C92)')).exists()))
|
| supportingInfo-c90-c91-c92 | error | Claim | 當Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C90、C91或C92，需提供檢驗(查)、影像報告、基因資訊、檢驗檢查中任一項資訊。 |
(diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C90|C91|C92)')).exists()) implies (supportingInfo.category.exists(coding.code = 'tests') or supportingInfo.category.exists(coding.code = 'imagingReport') or supportingInfo.category.exists(coding.code = 'geneInfo') or supportingInfo.category.exists(coding.code = 'examinationReport'))
|
| supportingInfo-tests | error | Claim | 當Claim.diagnosis.diagnosisCodeableConcept(國際疾病分類代碼)為C61，且Claim.item.modifier:continuation(續用註記)為2，需提供檢驗(查)。 |
(diagnosis.diagnosis.ofType(CodeableConcept).coding.where(code.matches('^(C61)')).exists() and (item.modifier.where(coding.system = 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status').coding.exists(code = '2'))) implies (supportingInfo.category.exists(coding.code = 'tests'))
|
This structure is derived from Claim
Summary
Mandatory: 33 elements(32 nested mandatory elements)
Must-Support: 56 elements
Prohibited: 17 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Other representations of profile: CSV, Excel, Schematron
以下概述了此Profile所需的RESTful FHIR互動功能。有關TWPAS支援的RESTful互動功能的完整清單，請參閱TWPAS Server能力聲明。
必須（SHALL） 支援透過查詢參數 id 查詢所有Claim：
(如何透過token查詢)
GET [base]/Claim?_id=[id]
GET [base]/Claim/[id]
例子：
(1) GET [base]/Claim?_id=bun-1
(2) GET [base]/Claim/bun-1
必須（SHALL） 支援透過查詢參數 identifier 查詢所有Claim：
(如何透過token查詢)
GET [base]/Claim?identifier=[code]
例子：
(1) GET [base]/Claim?identifier=20240831010109051701
必須（SHALL） 支援透過查詢參數 patient 查詢所有Claim：
(如何透過reference查詢)
GET [base]/Claim?patient={Type/}[id]
例子：
(1) GET [base]/Claim?patient=Patient/pat-min
(2) GET [base]/Claim?patient=pat-min
必須（SHALL） 支援透過查詢參數 func-type 查詢所有Claim：
(如何透過reference查詢)
GET [base]/Claim?func-type={Type/}[id]
例子：
(1) GET [base]/Claim?func-type=Encounter/enc-min
(2) GET [base]/Claim?func-type=enc-min
必須（SHALL） 支援透過查詢參數 _lastUpdated 查詢所有Claim：
(如何透過date查詢)
GET [base]/Claim?_lastUpdated={gt|lt|ge|le}[date]{&_lastUpdated={gt|lt|ge|le}[date]
例子：
(1) GET [base]/Claim?_lastUpdated=gt2026-10-01T14:17